Location: Columbia, SC
Positions: 3
Duration: 12 monthsProject:
This is a large project with a "startup" attitude. A majority of the team is
made up of experienced consultants, and we are seeking individuals who are
highly productive, very flexible, and can work in an environment where
ambiguity is common. Each team member is expected to contribute with minimal
supervision. The project is taking a different approach than most, and we
are seeking individuals who are strong collaborators, who want to make a
positive contribution to the State of South Carolina, and who do not need a
perfect roadmap ahead of them. The project will use modern technologies and
modern strategies, and the team cultivates "thought leadership." Candidates
who enjoy working on complex, change-oriented projects with motivated team
members will find this position attractive.The Replacement Medicaid Management Information System (MMIS) project is one
of the largest IT projects for the State of South Carolina. It is a
multi-year effort to replace the State's aging MMIS, eligibility system, and
related applications with a modern, service oriented architecture based
system. This project will be very complex and will demand exceptionally high
quality team members.RESPONSIBILITIES:
A Replacement MMIS Subject Matter Expert (SME) is responsible for evaluating
agency needs, as-is and to-be business processes, and technical designs to
provide analysis and advice on strategies for information technology
solutions and non-technical solutions. The majority of the system
development work will be outsourced to vendors and other State
organizations. Duties include:
. Requirements development execution, including the elicitation,
analysis, specification and validation.
. Documenting and analyzing agency business processes and recommending
improvements.
. Documenting and analyzing data requirements and relationships.
. Participate in the requirements management processes, including
change control; version control; tracking and status reporting; and
traceability.
. Providing requirement interpretation and guidance to technical and
test teams.
. Proactively identifying risks, issues, and action items leading to
possible solutions.
. Interacting with internal and external organizations (i.e. vendors,
State and Federal government agencies, State providers and beneficiaries,
and other stakeholders).
. Participating in standup of business operations supporting the
Replacement MMIS.
. Planning for, conducting, and reporting on testing and other quality
assurance activities.
. Other related activities.The Client is seeking multiple SMEs covering the breadth of functions within
the State's Medicaid agency with the business expertise and operations
experience, information technology project experience, and interpersonal
skills necessary to enable success on this high- visibility project. Subject
matter areas include provider management, member (beneficiary)
management/eligibility, claims (professional, institutional, pharmacy,
dental, durable medical equipment, transportation, etc.), third party
liability, financial management, reimbursement methodology, drug rebate,
prior authorization, managed care, behavioral health, long-term care,
program integrity, electronic health records, benefit plan administration,
etc.REQUIRED SKILLS (IN ORDER OF IMPORTANCE):
. Strong background and at least three years experience in healthcare
insurance operations (payer or provider side; government or commercial
side). Experience in multiple business areas is a plus.
. At least three years experience in healthcare insurance IT software/
systems implementations performing duties described in the "Daily
Duties/Responsibilities" section above. Three additional years in
implementation projects can substitute for three years of operations
experience.
. Ability to properly document business requirements.
. Ability to interpret business process and business data models.
. Vendor management experience.
. Superb written and oral communications skills, including the ability
to give presentations to executive management. Strong proficiency in English
is required.
. Impeccable integrity. This project will have very high visibility
and will impact significant expenditures of public funds. Candidates must be
confident with their abilities to make correct decisions and the courage to
speak out when necessary.
. Willingness and ability to effectively engage with people and
organizations on a continuous basis.PREFERRED SKILLS (IN ORDER OF IMPORTANCE):
. Understanding of the Medicaid Information Technology Architecture
(MITA).
. Understanding of the Medicaid Enterprise Certification Toolkit
(MECT).
. Experience in an outsourced healthcare insurance operations
environment.
. Experience on an outsourced IT development project.
. Experience in creating business process and business data models.
. Public sector procurement experience is a plus.
Positions: 3
Duration: 12 monthsProject:
This is a large project with a "startup" attitude. A majority of the team is
made up of experienced consultants, and we are seeking individuals who are
highly productive, very flexible, and can work in an environment where
ambiguity is common. Each team member is expected to contribute with minimal
supervision. The project is taking a different approach than most, and we
are seeking individuals who are strong collaborators, who want to make a
positive contribution to the State of South Carolina, and who do not need a
perfect roadmap ahead of them. The project will use modern technologies and
modern strategies, and the team cultivates "thought leadership." Candidates
who enjoy working on complex, change-oriented projects with motivated team
members will find this position attractive.The Replacement Medicaid Management Information System (MMIS) project is one
of the largest IT projects for the State of South Carolina. It is a
multi-year effort to replace the State's aging MMIS, eligibility system, and
related applications with a modern, service oriented architecture based
system. This project will be very complex and will demand exceptionally high
quality team members.RESPONSIBILITIES:
A Replacement MMIS Subject Matter Expert (SME) is responsible for evaluating
agency needs, as-is and to-be business processes, and technical designs to
provide analysis and advice on strategies for information technology
solutions and non-technical solutions. The majority of the system
development work will be outsourced to vendors and other State
organizations. Duties include:
. Requirements development execution, including the elicitation,
analysis, specification and validation.
. Documenting and analyzing agency business processes and recommending
improvements.
. Documenting and analyzing data requirements and relationships.
. Participate in the requirements management processes, including
change control; version control; tracking and status reporting; and
traceability.
. Providing requirement interpretation and guidance to technical and
test teams.
. Proactively identifying risks, issues, and action items leading to
possible solutions.
. Interacting with internal and external organizations (i.e. vendors,
State and Federal government agencies, State providers and beneficiaries,
and other stakeholders).
. Participating in standup of business operations supporting the
Replacement MMIS.
. Planning for, conducting, and reporting on testing and other quality
assurance activities.
. Other related activities.The Client is seeking multiple SMEs covering the breadth of functions within
the State's Medicaid agency with the business expertise and operations
experience, information technology project experience, and interpersonal
skills necessary to enable success on this high- visibility project. Subject
matter areas include provider management, member (beneficiary)
management/eligibility, claims (professional, institutional, pharmacy,
dental, durable medical equipment, transportation, etc.), third party
liability, financial management, reimbursement methodology, drug rebate,
prior authorization, managed care, behavioral health, long-term care,
program integrity, electronic health records, benefit plan administration,
etc.REQUIRED SKILLS (IN ORDER OF IMPORTANCE):
. Strong background and at least three years experience in healthcare
insurance operations (payer or provider side; government or commercial
side). Experience in multiple business areas is a plus.
. At least three years experience in healthcare insurance IT software/
systems implementations performing duties described in the "Daily
Duties/Responsibilities" section above. Three additional years in
implementation projects can substitute for three years of operations
experience.
. Ability to properly document business requirements.
. Ability to interpret business process and business data models.
. Vendor management experience.
. Superb written and oral communications skills, including the ability
to give presentations to executive management. Strong proficiency in English
is required.
. Impeccable integrity. This project will have very high visibility
and will impact significant expenditures of public funds. Candidates must be
confident with their abilities to make correct decisions and the courage to
speak out when necessary.
. Willingness and ability to effectively engage with people and
organizations on a continuous basis.PREFERRED SKILLS (IN ORDER OF IMPORTANCE):
. Understanding of the Medicaid Information Technology Architecture
(MITA).
. Understanding of the Medicaid Enterprise Certification Toolkit
(MECT).
. Experience in an outsourced healthcare insurance operations
environment.
. Experience on an outsourced IT development project.
. Experience in creating business process and business data models.
. Public sector procurement experience is a plus.
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