Senior Project Manager - Medicaid

Company: The Computer Merchant, LTD.
Location: Waterbury
Posted on: April 2, 2025

Job Description:

JOB TITLE: Senior Project Manager-Medicaid

Apply fast, check the full description by scrolling below to find out the full requirements for this role.
JOB LOCATION: Waterbury VT
WAGE RANGE*: $85-$90
JOB NUMBER: 25-02619

REQUIRED EXPERIENCE:Strong Project Management experience within Medicaid operations
Within Medicaid Project Management must have strong experience with Third-Party Liability (TPL) & Special Investigations Unit (SIU)
Ability to manage a project in accordance with the ADS EPMO project lifecycle (ADS EPMO Project Lifecycle Phases / Process Flow)
Strong organizational skills
Strong communication skills
Ability to manage a large project's triple constraint
Ability to manage multiple levels of project resources (i.e. project SME's, all levels of stakeholder engagement, and vendors)
Manage multiple contracts supporting the execution of scope


Qualifications Bachelor's degree or equivalent experience required
5+ years of Direct work experience in project management capacity, Proven experience with people management, strategic planning, risk management, and change management


Working Conditions Remote and Onsite Office Setting When Requested
Work Hours Between 8 am - 5 pm Central Time, or as Requested


JOB DESCRIPTION

Serve as a part-time project manager coordinating and managing all activities related to Medicaid Third-Party Liability (TPL) & Special Investigations Unit (SIU).

Duties and Responsibilities BACKGROUND The ADS EPMO is seeking multiple Project Managers to support IT projects in partnership with the Agency of Human Services (AHS), Department of Vermont Health Access (DVHA). The scope of the effort is focused on identifying Project Managers who have the experience necessary to manage a project in accordance with ADS EPMO guidelines and the outlined approach, can assess the current state of a project and articulate, then execute, a path forward, and leverage the resources available to them to successfully assist in a solution delivery.
Interoperability Phase II: The project aims to achieve successful completion of enhancing access to health information for patients, providers, and payers. CMS Interoperability Final Rule (CMS0057-F) has mandated seven workstream implementations. Work currently in progress includes business validation of the approach to be taken and expects to complete this by May 2025 to ensure 2 of the 7 workstreams meet the federal implementation date of 1/1/2026. The remaining 5 workstreams have an implementation expectation of 1/1/2027. The anticipated approach is to utilize existing solutions however, there remains a vendor engagement aspect which the Project Manager will be required to hold accountable.

This effort requires 20 hours a week dedication.

Third-Party Liability (TPL) & Special Investigations Unit (SIU) CMS requires State Medicaid programs to utilize a SURS (Surveillance Utilization Review Subsystem). For the Vermont Department of VT Health Access, SIU designates SURS as a Microsoft Access case management file. As the programs take on more cases, when utilized, the Access database has become unstable (risks data loss), slow, and is not built for future use as our SURS system. SIU seeks to secure appropriate case workflows and the necessary file permissions to cases. TPL operates primarily manual-based case processing and shares a significant amount of requirements with the SIU Program. Together, the two programs are looking to work with a single vendor and procure a solution for both. This project is currently in requirements analysis and Request for Proposal drafting.

This effort requires 20 hours a week dedication.


Equal Opportunity Employer, including Veterans and Individuals with Disabilities

* While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations. Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.

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