Management System Contract Manager

General Description

This position manages and oversees benefit and provider management systems for Wyoming’s statewide Medicaid program, including oversight of the vendors and systems that conduct reimbursement, expenditure management, and communication for programs that comprehensively pay over $500 million annually. This position directly manages the Benefits Management System (BMS) contract to provide vendor oversight and performance monitoring to ensure accurate, appropriate, and efficient processing of over three million claims per year for Medicaid clients and enrolled providers, and a large array of other mission‑critical functions.

• Independently directs and oversees the Benefits Management System (BMS) contract and system that processes benefit payments of over $1, ($1 billion) per biennium.
• Collaborate with business owners and policy groups throughout Medicaid and CHIP to support their business needs.
• Directs, approves, and oversees the internal system changes, requests for operation, benefit payment processing, and federal mandate requirements.
• Maintains statistical reporting standards for the Medicaid program and monitors benefit and provider‑related reporting.
• Accounts for code determination and financial reporting for the benefit payment processing functions.
• Manages and directs system security for the Division of Healthcare Financing and other programs related to Medicaid payments.
• Coordinates and manages the state‑wide annual IT audit and federal audits related to the systems this position oversees.
• Processes invoices and other contract materials.
• Manages a system vendor budget of $8 million to $10 million annually and oversees related contracts such as additional licensing or services.

• Bachelor’s degree or equivalent experience and training, typically in business, policy, planning, information technology, public administration, healthcare administration, or other closely related fields.
• Minimum of five years of professional work experience in business, accounting, healthcare administration, insurance, or public administration.
• Five years of experience in managing a budget, reporting, and IT project experience.
• Minimum of three years supervising programs and/or systems.
• Demonstrated ability to balance multiple demands on time and resources when assigning projects or delegating responsibilities to team members, including interpersonal relations, team building, consensus building, goal setting, and team motivation.
• Demonstrated ability to research and analyze complex problems and identify options and solutions; decision‑making and evaluation of results.
• Demonstrated skill in public speaking and oral and written communication at a variety of levels and with multiple audiences.

• Minimum requirement:
  Bachelor’s Degree (typically in Healthcare).
• Applicants with 2–4 years of progressive work experience in Health Programs may also qualify if they have acquired knowledge at the level of a Health Program Manager I.
• Alternatively, 5–7 years of progressive work experience in Health Programs may qualify in lieu of a bachelor’s degree.

• The employee may sit comfortably to perform the work; however, there may be some walking, standing, bending, carrying light items, driving an automobile, etc.

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

For more information, contact the Human Resources division at wdhr.