Sedna Consulting Group Looking for Sr. Project Manager at Remote Full Time

Responsibilities:

• Consult with Customer leadership on product strategy and feature roadmap associated with the implementation and use of the Medicaid Enterprise Systems (MES) modules.
• Manage project roadmap to ensure that enhancements and epics for MES modules are completed in accordance with Federal and State guidance and within the required timeframes for implementation.
• Support impacted stakeholders for all enhancements and epics for MES modules and provide the opportunity for stakeholders to impact prioritization of module tasks.
• Coordinate with CMS, partners, vendors, legal counsel and other program staff on regulations regarding the Medicaid program to establish project requirements and to resolve conflicts timely.
• Provide day-to-day management of MES module roadmap activities.
• Identify and escalate impediments and risks to project roadmap.
• Activity and resource planning.
• Analyze project risks and issues, help identify ways to mitigate risks.
• Process monitoring.
• Monitor project deliverables.
• Identify project resources and works with the Agency project personnel and contractors to assign individual responsibilities.
• Review deliverables prepared by the sprint team before sending to production.

Expertise and/or relevant experience in the following areas are mandatory:

• Minimum two (2) years of professional experience supporting technical projects.
• Experience presenting information to technical and non‐technical audiences.
• Excellent analytical skills, effective organizational and time management skills.
• Enhanced attention to detail and follow-up, and verbal/written communications skills

Expertise and/or relevant experience in the following areas are desirable but not mandatory:

• Minimum of two (2) years of professional experience in managed care enrollment or managed care compliance.
• Minimum of two (2) years of professional experience in claims processing, electronic data interchange (EDI), and/or benefit administration.
• High level of expertise and understanding of the day-to-day functions of MES impacting fee-for-service claims adjudication, Managed Care Entity (MCE) encounter processing, and relationship management between the FI and other State vendors, including, but not limited to, the MCEs, Enrollment Broker (EB), and Third Party Liability (TPL) relative to claims and encounter processing.
• Professional experience with FHIR, HL7, and/or clinical data exchange or Patient Access and Interoperability (PAI) Final rule (CMS-9115-F).
• Minimum two (2) years of professional experience in electronic visit verification system utilization or administration; or electronic visit verification compliance.
• High level of expertise and understanding of the day-to-day functions of enrollment and eligibility activities, and relationship management between the FI and other State vendors included but not limited to the MCEs, EB, and TPL relative to MEDS.
• High level of experience with Electronic Visit Verification (EVV) system users which may include, but are not limited to, personal care and home health provider agencies, support coordination agencies, adult day healthcare centers.

Minimum two (2) years of Medicaid Home Community Based Service programmatic or management experience, which may include special programs such as Money Follows the Person and Program of All-Inclusive Care for the Elderly.

Job Type: Contract

Salary: $75.00 – $80.00 per hour

Schedule:

• 8 hour shift

Experience:

• Medicaid Enterprise Systems (MES): 4 years (Required)
• managed care enrollment or managed care compliance: 4 years (Required)
• Electronic data interchange (EDI): 4 years (Required)
• FHIR, HL7: 4 years (Required)
• Clinical data exchange: 4 years (Required)
• Patient Access & Interoperability (PAI): 4 years (Required)
• Electronic Visit Verification (EVV) system: 4 years (Required)
• Medicaid Home Community Based Service: 4 years (Required)

Work Location: Remote