CL - Information Systems Architect - Consultant

Job Description: Please read :
Max Bill Rate: NA
Bachelors degree required
PMP required
10 years of experience in commercial healthcare

SCOPE OF THE PROJECT:
SCDHHS is the State Medicaid Agency for South Carolina. This project is focused on the replacement of the State s Medicaid Management Information System (MMIS). The project is a major undertaking for SCDHHS and requires major transformation of culture processes and technology. This project also supports the Department s transition from primarily a feeforservice payor of claims towards a program and policy driver for health outcomes primarily through managed care programs.

The Replacement MMIS project is a multiyear effort to replace the State s aging MMIS and related applications with more modern capabilities along with corresponding business operations services.

The goal of the RMMIS program will be incremental and modular in nature with a focus on configurable and scalable integrations which allow for more flexibility and reduces time and cost necessary to respond to federal and state enhancements.

A key strategy of the project is to remove Medicaidspecific requirements in order to allow for easier customization increased vendor competition and reduced cost. SCDHHS intends to retain control over policy business rules and reference data. SCDHHS retains control over an Operational Data Store (ODS) and all EDI components.

The major subproject components of the Replacement MMIS Program are:
Provider Management
Analytics
Accounting and Finance
Commercial Administrative Services Organization (ASO) for FFS Claims

Supporting the projects are:
Technical Integration
Project Management Integration
Commercial Integration

DAILY DUTIES / RESPONSIBILITIES:
The Replacement MMIS Business Integration Lead will work with the Program Manager and the Lead Project Manager and will support the Project Management team to ensure the commercial principles business goals and values of the project are met.

Duties include:
Perform business process analysis and performance assessments for the assigned projects
Train and mentor team members in delivering high quality business solutions that meet the overall strategy and vision
Build positive relationships with clients and proactively address specific needs
Lead business design sessions within assigned modules and work streams
Advocate and lead business integration in support of the RMMIS ASO project
Provide backup role to the ASO product owner
Drive though dynamic discussion efficient configuration of data within the core modules of RMMIS projects
Provide liaison role between business and IT verticals
Ensure project deliverables for each project connect to the operational principles
Coordinate priorities and resources between multiple projects.
Provide updates on status and issues for all assignments
Participate in scheduled operational meetings and routine team leads meetings
Lead crossfunctional meetings and produce business designs that integrate functionality across modules
Facilitate sessions to effectively resolve issues if any.
Provide recommendations of appropriate resources if necessary to ensure assignments are completed within given time and budget.
Create and maintain key performance indicators to indicate project progress toward business integration goals.

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
At least ten years of experience in commercial healthcare.
At least five years experience in State Medicaid payer system integration and delivery
Experience with inner workings of cross functional projects
Familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles.
Familiarity with standard data structures electronic data interchange processes and related file formats.
Knowledge of Federal Certification requirements and processes is preferable.
Interest skill and ability to innovate including business processes methods/procedures and technology.
Ability to effectively work and communicate in both oral and written with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s).

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
Large business and technology integration
Commercial integrations with Medicaid or other Government operations
Project management

REQUIRED EDUCATION:
Bachelor Degree

REQUIRED CERTIFICATIONS:
PMP Certification
Additional Sills: Experience with inner workings of cross functional projects (required expert currently using 6years); Familiarity with standard data structures electronic data interchange processes and related file formats (required expert currently using 6years); Interest skill and ability to innovate including business processes methods/procedures and technology (required expert currently using 6years); Commercial integrations with Medicaid or other Government operations (preferred expert currently using 6years) Skills: Administrative Verbal Communication Skills Yes 1 Expert Currently Using 6 Years Administrative Written Communication Skills Yes 1 Expert Currently Using 6 Years Education Bachelors Degree Yes 1 Expert Currently Using 6 Years MMIS Medicaid Management Informaiton System Experience with the Medicaid Information Technology Architecture (MITA) principles and framework Yes 1 Expert Currently Using 6 Years MMIS Medicaid Management Informaiton System Commercial healthcare Yes 1 Expert Currently Using 6 Years MMIS Medicaid Management Informaiton System Knowledge of Federal Certification requirements and processes Yes 1 Expert Currently Using 6 Years Program Management Project Management Professional (PMP) certification No 1 Expert Currently Using 6 Years Specialties Medicaid or Healthcare Delivery Systems Yes 1 Expert Currently Using 6 Years Specialties Integration No 1 Expert Currently Using 6 Years Specialties Project Management No 1 Expert Currently Using 6 Years