Project Manager Healthcare Medicaid

Title: IT Healthcare Consultant- Project Manager Medicaid

Location: Columbia, SC (Hybrid onsite at least 3 days per week)

Position Type: W2 Contract

Job Description: We are seeking an experienced IT Healthcare Consultant/Project Manager to lead day-to-day operational support for business-critical healthcare systems, including claims, enrollment, encounter processing, payment, and related integrations. The ideal candidate will bring strong expertise in healthcare systems operations, project management, claims and encounter processing, vendor management, and incident management. This role will oversee production support, issue resolution, service-level performance, release coordination, and stakeholder communication in a fast-paced environment.

The consultant will manage cross-functional technical teams, coordinate external vendors, maintain operational documentation, and ensure systems remain stable, compliant, and responsive to business needs. Candidates must be comfortable supporting on-call and after-hours activities for production incidents and releases. Strong communication, leadership, documentation, and process-management abilities are essential.

• Lead operational support for healthcare technology systems.
• Manage claims-processing and encounter-processing operations.
• Support enrollment, payment, and related business functions.
• Oversee production support and help-desk activities.
• Coordinate incident, issue, and problem management processes.
• Track, document, escalate, and resolve production tickets.
• Ensure timely resolution of critical system issues.
• Lead internal and external technical escalations.
• Communicate issue status and outcomes to stakeholders.
• Manage and prioritize team workloads.
• Provide guidance and direction to technical staff.
• Coordinate activities with external technology vendors.
• Manage service-level agreements and performance metrics.
• Support system implementations and enhancement projects.
• Lead release-management planning and readiness activities.
• Coordinate pre-implementation, go-live, and post-implementation support.
• Support change-management processes and approval gates.
• Perform backlog grooming and maintenance.
• Develop and maintain Standard Operating Procedures (SOPs).
• Maintain technical documentation, process documentation, and escalation procedures.
• Apply knowledge of the System Development Life Cycle (SDLC).
• Ensure compliance with security and regulatory requirements.
• Monitor findings and corrective actions through completion.
• Prepare operational reports and stakeholder presentations.
• Support on-call and after-hours incident response.
• Foster a professional, collaborative, and productive team environment.
• Require 5 years of healthcare systems operations, claims, or encounter-processing experience.
• Require 5 years of project-management experience supporting system implementations or enhancements.
• Require 3 years of experience managing external system-development vendors.
• Bachelor s degree in a technical, business, or healthcare-related field preferred; equivalent experience may be considered.
  
  

Preferred Experience

• 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 software
• Experience with writing standard operating procedures for new system implementations.
• AWS Cloud Certifications