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Project Manager - Healthcare

Refulgent Technologies Inc.Columbia, SC🇺🇸United StatesPosted 28 Aug 2026

Quick Overview

Seniority
Mid Senior
Work mode
Hybrid
Location
Columbia, SC, United States
Posted
23 hours ago

Job Description

Job :IT Healthcare Consultant - Project Manager

Location: Columbia, SC

Client is looking for an IT Healthcare Consultant - Project Manager - Consultant who

will be the lead for MMIS Medicaid Systems Operational Management. This position will lead teams that support business-critical operations for MCO enrollment, claims and encounter processing and payment and other support functions.

DAILY DUTIES / RESPONSIBILITIES:

  • Oversee, coordinate, and perform operations and support activities for MMIS, Encounter Processing System, and other supporting systems. To include communication and coordination with vendors, Office of Cyber Security, Enterprise Architecture, etc.
  • Design and develop desk aides and process flows for new and existing service lines.
  • Train team members to use desk aides, process flows, and ticketing system to perform operational support.
  • Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives. These teams provide production support, helpdesk, interface/EDI support, and stakeholder monitoring and user acceptance testing
  • Identifies and mitigates operational issues and ensures decisions and actions are well-documented.
  • Handles internal and external escalations and requests and ensures they are satisfactorily resolved, communicating issues and outcomes to appropriate personnel. Ensures work is assigned appropriately and escalations are resolved in a timely and effective manner.
  • Ensures compliance with security (CMS, SSA, etc.) and monitors all findings and recommendations to completion.
  • Promotes workforce engagement and a safe, professional, and productive work environment for all team members
  • Implements, monitors and follows Standard Operating Procedures and alerts team when practice differs from SOP.
  • Oversees release management activities stakeholder communication, pre- implementation planning, readiness checks, and post-implementation monitoring.
  • Provide support to change management by performing and coordinating backlog grooming and maintenance and ensuring compliance with appropriate approval gates.

REQUIRED SKILLS (RANK IN ORDER OF

IMPORTANCE):

  • Bachelor s degree in a technical, business, or healthcare field. 5+ years of equivalent experience in business/systems analysis and/or computer systems development/modification may be substituted.
  • 3+ years of prior experience managing system operations and or administrative program functions in healthcare environment.
  • 5+ years of experience in project/program management managing system implementations or enhancements.
  • Ability to provide incident management on call and after hours.

PREFERRED SKILLS (RANK IN ORDER OF

IMPORTANCE):

  • Prior experience managing operations of Medicaid Enterprise systems.
  • Ability to make presentations and prepare reports.
  • Knowledge of Medicaid eligibility, enrollment, and MMIS domain concepts
  • Experience with ticketing software
  • Experience with writing standard operating procedures for new system implementations.
  • AWS Cloud Certifications

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