Senior Healthcare Business Systems Analyst - HYBRID (SC resident/willing to relocate to SC) - W2 Only

Job Description:

***Only W2 resumes are accepted

Work Location: Hybrid (3 days in office, 2 days remote). Onsite for 30-90 days - schedule will turn to hybrid at the managers discretion.

Candidate Location: Candidate MUST be a SC resident or willing to relocate to SC prior to starting the role at their own expense. 

SCDHHS 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 and encounter processing and payment and other support functions.

DAILY DUTIES / RESPONSIBILITIES:

·      Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems. To include communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, etc.

·      Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. These teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring and

·      Oversee incident and issue management. Ensures documentation, tracking, escalation and resolution for all ticket types. Ensures timely resolution of production issues.

·      Identifies and mitigates operational issues and ensures decisions and actions are well-documented.

·      Handles internal and external escalations and requests and ensures they are satisfactorily resolved, communicating issues and outcomes to appropriate personnel. Ensures work is assigned appropriately and escalations are resolved in a timely and effective manner.

·      Ensures compliance with security (CMS, SSA, etc.) and monitors all findings and recommendations to completion.

·      Works with contract monitor to ensure SLAs are set and monitored.

·      Responds promptly to inquiries.

·      Promotes workforce engagement and a safe, professional, and productive work environment for all team members

·      Implements, monitors and follows Standard Operating Procedures and alerts team when practice differs from SOP.

·      Oversees release management activities 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.

Required Skills

·      Bachelor’s degree in a technical, business, or healthcare field. 5 years of equivalent experience in business/systems analysis and/or computer systems development/modification may be substituted.

·      5 years of prior experience managing system operations and or administrative program functions for claims and/or encounter processing in healthcare environment.

·      5 years of experience in project management – managing system implementations or enhancements.

·      3 years of experience manage external vendors who provide system development.

·      Ability to provide incident management on call and after hours

Preferred Skills

·       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 

Additional Skills:

·       Excellent communication skills with staff ranging from frontline to executive management

·       Ability to manage work and provide guidance

·       Experience assigning/overseeing team workload

·       Knowledge of system development lifecycle

·       Strong documentation and process management ability

·       Excellent communication skills with staff ranging from frontline to executive management