Consultant, IT Project Manager, IT​/Tech

Consultant (Columbia, SC)

Client is looking for an IT Healthcare Consultant – Project Manager – Consultant who will be the lead for MMIS Medicaid Systems Operational Management. This position will lead teams that support business-critical operations for MCO enrollment, claims, encounter processing and payment, and other support functions.

• Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems, including communication with vendors, Office of Cyber Security, Enterprise Architecture, etc.
• Maintain an effective organizational team and motivate diverse staff to accomplish mission‑critical operations and objectives. Teams provide production support, help desk, interface/EDI support, stakeholder monitoring.
• Oversee incident and issue management, ensuring documentation, tracking, escalation and resolution for all ticket types, and timely resolution of production issues.
• Identify and mitigate operational issues, ensuring decisions and actions are well‑documented.
• Handle internal and external escalations and requests, ensuring satisfactory resolution and effective communication of issues and outcomes to appropriate personnel.
• Ensure compliance with security (CMS, SSA, etc.) and monitor all findings and recommendations to completion.
• Work with contract monitor to ensure SLAs are set and monitored.
• Respond promptly to inquiries.
• Promote workforce engagement and a safe, professional, productive work environment for all team members.
• Implement, monitor and follow Standard Operating Procedures, alerting the team when practice differs from SOP.
• Oversee release management activities, including stakeholder communication, pre‑implementation planning, readiness checks, and post‑implementation monitoring.
• Provide support to change management by performing and coordinating backlog grooming and maintenance and ensuring compliance with appropriate approval gates.

• Bachelor’s degree in a technical, business, or healthcare field, or 5+ years of equivalent experience in business/systems analysis and/or computer systems development/modification.
• 5+ years of prior experience managing system operations and/or administrative program functions for claims and/or encounter processing in a healthcare environment.
• 5+ years of experience in project management, managing system implementations or enhancements.
• 3+ years of experience managing external vendors who provide system development.
• Ability to provide incident management on call and after hours.
• AWS Cloud Certifications.

• Prior experience managing operations of Medicaid Enterprise systems.
• Ability to make presentations and prepare reports.
• Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts.
• Experience with ticketing systems.

EOE Protected Veterans/Disability