IT Healthcare Consultant – Project Manager – Consultant

Job Title: IT Healthcare Consultant – Project Manager – Consultant (12761)

Location: Columbia, SC 29210

Work Arrangement: Hybrid – 3 days onsite and 2 days remote

Initial Onsite Requirement: Candidate may be required to work fully onsite for the first 30–90 days. The hybrid schedule will begin at the manager’s discretion.

Contract Duration: 12 months

Interview Process: One virtual interview

Candidate Location: Candidate must currently reside in South Carolina or be willing to relocate to South Carolina at their own expense before starting.

Position Overview: This position will focus on the Medicaid Management Information System, including existing MMIS platforms and replacement systems being implemented. The consultant will lead teams supporting business-critical Medicaid operations, including Managed Care Organization enrollment, claims and encounter processing, payment operations, production support, help desk services, EDI/interface support, and stakeholder monitoring.

The environment is fast-paced, and the selected consultant must be available to support production releases, critical incidents, and unplanned issues outside normal business hours when required.

Key Responsibilities

• Lead operational management and production-support activities for MMIS, the Encounter Processing System, and related Medicaid systems.
• Coordinate activities with external vendors, the Office of Cyber Security, Enterprise Architecture, business stakeholders, and technical teams.
• Lead and motivate teams responsible for production support, help desk operations, EDI and interface support, and stakeholder monitoring.
• Oversee incident, issue, and ticket management processes, including documentation, assignment, tracking, escalation, and timely resolution.
• Provide on-call and after-hours incident-management support for production releases and unplanned system issues.
• Identify, document, and mitigate operational risks and production issues.
• Manage internal and external escalations and ensure issues are assigned, communicated, and resolved effectively.
• Oversee external vendors responsible for system development, maintenance, enhancements, and production support.
• Work with contract-monitoring teams to establish, track, and enforce service-level agreements.
• Ensure compliance with applicable CMS, SSA, cybersecurity, and operational requirements.
• Monitor security findings and recommendations through completion.
• Develop, implement, monitor, and maintain Standard Operating Procedures.
• Identify operational practices that do not align with approved SOPs and coordinate corrective actions.
• Oversee release-management activities, including stakeholder communications, implementation planning, readiness assessments, approval gates, and post-implementation monitoring.
• Support change-management activities through backlog grooming, backlog maintenance, documentation, and governance compliance.
• Assign and oversee team workloads while ensuring mission-critical operational objectives are met.
• Prepare reports, presentations, status updates, issue summaries, and executive-level communications.
• Promote a professional, collaborative, safe, and productive working environment.

Required Qualifications

• Bachelor’s degree in a technical, business, healthcare, information systems, or related field.

Substitution: Five or more years of equivalent experience in business analysis, systems analysis, or computer systems development and modification may substitute for the degree requirement.

• Five or more years of experience managing system operations or administrative program functions involving healthcare claims and/or encounter processing.
• Five or more years of project-management experience leading system implementations, replacements, upgrades, or enhancements.
• Three or more years of experience managing external vendors that provide system development or technical services.
• Ability and willingness to provide on-call and after-hours incident-management support.
• Current AWS Cloud certification.

Preferred Qualifications

• Experience managing the operations of Medicaid Enterprise Systems.
• Knowledge of Medicaid eligibility, enrollment, managed care, claims, encounters, payments, and MMIS domain concepts.
• Knowledge of the System Development Life Cycle.
• Experience using incident-management, service-management, or ticketing software.
• Experience developing Standard Operating Procedures for new system implementations.
• Experience overseeing release management, change management, production support, and operational readiness.
• Ability to create executive presentations, operational reports, incident summaries, and project documentation.
• Experience assigning work and overseeing the workload of technical or operational teams.
• Strong documentation, process-management, and organizational skills.

Required Professional Skills

• Excellent written and verbal communication skills.
• Ability to communicate effectively with frontline staff, technical teams, vendors, senior leadership, and executive management.
• Strong leadership and team-management capabilities.
• Strong incident, escalation, risk, and issue-management skills.
• Ability to manage multiple priorities in a fast-paced, business-critical healthcare environment.
• Ability to provide clear direction and guidance to technical and operational teams.
• Strong analytical, decision-making, documentation, and problem-solving skills.