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IT Healthcare Consultant
Ref No.: 14-01224
Location: Columbia, South Carolina
Department of Health and Human Services
Columbia, SC
12 Months
Remote work availability : 25%


IT Healthcare Consultant.

SCOPE OF THE PROJECT:

The IV&V project team performs verification and validation activities for the Replacement MMIS and Medicaid Eligibility programs for SCDHHS. The PM will evaluate project artifacts and take a lead role in providing input to the CMS report on a monthly basis under the direction of the Project Director. The primary focus of this position will be on the Provider and ASO subprojects with a secondary focus on other MMIS subprojects as needed.

The Replacement MMIS and Medicaid Eligibility 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 many of the State's aging Medicaid systems with modern technologies and supporting business operations.

OBJECTIVES TO BE FULFILLED BY CANDIDATE:
The IV&V Project Manager Provider and ASO is responsible for cost, schedule, and results of verification and validation activities for the Replacement MMIS and Member Management projects for SCDHHS. Duties include:
Review Provider and ASO project artifacts on an ongoing basis
Perform independent review of project deliverables and processes
Identify areas of risk to cost, schedule, scope, and quality on the projects
Provide recommendations on risk mitigation or contingency options
Identify deviations from plans or execution of those plans that may jeopardize the project(s)
Perform all objectives without conflict of interest (or appearance thereof) and remain neutral with observations/decisions involving all impacted parties
Ensure all proper communications have been identified, documented and are taking place
Review project deliverables to the extent necessary to confirm their quality
Document findings of IV&V activities so that SCDHHS and CMS can use the information in their decision-making processes
Participate in quality and testing activities to the extent necessary to confirm that these processes are properly identifying defects and that the defects are being addressed
Serve as "honest broker in investigating post-implementation issues with systems and business operations
Provide reports detailing the work planned, the work currently in progress, and work recently completed

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):

Extensive experience developing a Provider sub-system as a component of an RMMIS or commercial healthcare insurance system
5+ years of supervisory leadership experience, preferably in an Administrative Services Organization (ASO) or commercial health insurance
10+ years of IT project experience, at least three years of which must be in large projects exceeding 100,000 hours and 2+ years duration
2+ years of Medicaid or Provider project experience with a strong understanding of insurance concepts and familiarity with:
Administrative Services Organizations
State Medicaid Manual
Medicaid IT Architecture (MITA)
Medicaid Enterprise Certification Toolkit (MECT)
US Code and Code of Federal Regulations concerning Medicaid
Ability to see big concepts while also understanding the details behind those concepts
Ability to effectively communicate to executive management, line management, project 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.

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):

Project Management Professional (PMP) training and certification
CMMI training and work experience
Ability to apply metrics to technology projects
IV&V experience leading teams on Public Sector projects
Author or co-author of IV&V reports to CMS
Solid understanding of CMS statutes and regulatory requirements for ACA and MMIS.

REQUIRED EDUCATION:
Bachelor's degree in Information Technology or equivalent experience.

PUBLIC SECTOR/GOV'T EXPERIENCE REQUIRED?
Yes, minimum of 5 years
Category
Name
Required
Importance
Level
Last Used
Experience
Administrative Verbal Communication Skills Yes 1
Administrative Written Communication Skills Yes 1
Education Medicaid Management Information System (MMIS) experience Yes 1
Miscellaneous Large Project Experience (exceeding 100,000 hours and at least 2 years duration Yes 1
Miscellaneous Presentation Skills Yes 1
Miscellaneous Prinicipal author of IV&V reports to CMS No 1
MMIS - Medicaid Management Informaiton System US Code and Code of Federal Regulations (CFR) regarding the Medicaid program Yes 1
MMIS - Medicaid Management Informaiton System Commercial healthcare Yes 1
MMIS - Medicaid Management Informaiton System MECT - Medicaid Enterprise Certification Toolkit Yes 1
MMIS - Medicaid Management Informaiton System Medicaid Yes 1
MMIS - Medicaid Management Informaiton System MITA - Medicaid Information Technology Architecture Yes 1
MMIS - Medicaid Management Informaiton System CMS No 1
Program Management Supervisory Leadership Experience Yes 1
Program Management PMP No 1
Specialties CMMI No 1
Specialties Public Sector No 1
Additional Skills: Extensive experience developing a Provider sub-system as a component of an RMMIS or commercial healthcare insurance system.
Ability to see big concepts while also understanding the details behind those concepts
Ability to effectively communicate to executive management, line management, project 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.
Project Management Professional (PMP) training and certification
CMMI training and work experience
Ability to apply metrics to technology projects
IV&V experience leading teams on Public Sector projects
Author or co-author of IV&V reports to CMS
Solid understanding of CMS statutes and regulatory requirements for ACA and MMIS.