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Department of Health and Human Services
Remote work availability - 25%
SCOPE OF THE PROJECT:
The IV&V project performs verification and validation activities for the Replacement MMIS and Member Management program for SCDHHS. The IV&V Regulatory and Policy SME will work with a team of 5-7 individuals charged with providing crucial project evaluation information to decision makers.
The Replacement MMIS and Member Management projects are among the most complex IT projects taken on by the State's Department of Health and Human Services. This project is a multi-year effort to replace the State's aging Medicaid eligibility and enrollment systems and MMIS with modern technologies and supporting business operations.
OBJECTIVES TO BE FULFILLED BY CANDIDATE:
The IV&V Regulatory and Policy SME is responsible for verification and validation of project artifacts, technical, testing, and other quality management processes and artifacts for the MMIS and Member Management projects for SCDHHS. Duties include:
Perform an independent review of the system's ability to fulfill State and Federal regulatory and policy requirements.
Perform an independent review of procurement documents authored by the State; provide advice and guidance on policy, legislative and regulatory issues.
Work closely with the IV&V project team; advise on CMS and State regulation and compliance.
Assist the IV&V Project Director to author CMS reports by compiling input and content provided by Technical Consultants and other IV&V staff.
Serve as a regulatory and policy advisor to the IV&V Project Director.
Identify areas of project risk and make recommendations on managing and mitigating these risks.
Document results of reviews and analyses promptly and with superb accuracy and impartiality.
Attend project meetings to maintain a high level awareness of project status and trends.
Other related duties, as assigned.
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
Medicaid experience must have previously held a Sr. level regulatory and policy position for 5+ years which illustrates a deep understanding of State and CMS requirements and culture.
Professional experience authoring complex formal written documents for State or Federal government agencies for 5+ years.
Work experience must include the business management of healthcare related programs and the computing systems that support them.
Ability to see big concepts while also understanding the details behind those concepts.
Ability to effectively communicate to executive management, line management, technical management, and team members.
Superb written and oral communications skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
Solid understanding of legislative and regulatory principles.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
Past experience with CMS and ONC programs and initiatives for State Department of Health and Human Services
State Medicaid Manual
Medicaid IT Architecture (MITA)
Medicaid Enterprise Certification Toolkit (MECT)
US Code and Code of Federal Regulations concerning Medicaid
The Patient Protection and Affordable Care Act
Bachelor's degree, preferably in a business field or equivalent experience; law degree preferred.
PUBLIC SECTOR/GOV'T EXPERIENCE REQUIRED?
Yes (previous Regulatory and Policy Medicaid experience in a Sr. leadership role is required)
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