Healthcare Project Manager MMIS 10 monthsQuincy MA Our client is seeking an exceptional individual to join their team. They are seeking a Project Manager to lead the implementation of the federally mandated Advancing Interoperability and Improving Prior Authorization Processes Final Rule. The client is responsible for administering the Medicaid program. The agency provides health benefits, and assistance paying for them for qualified children, families, seniors, and people with disabilities living in the state. This is an exciting opportunity to participate in this innovative initiative to enhance care coordination amongst members, providers, and payers through the use of Application Programming Interfaces (API) and mobile applications. These tools will further enable members to easily access their healthcare data and facilitate interoperable data exchanges between providers and payers. The Project Manager reports to the Director of Business & Systems Integration and is responsible for managing the overall implementation of the CMS Advancing Interoperability and Improving Prior Authorization Processes Final Rule. The Interoperability PM will manage the agency’s planning and implementation vendors, the project team, and its activities, as well as key administrative and reporting activities. The PM will also manage and maintain the project timeline. This includes, but is not limited to: + **January 1, 2026:** Ensure the requests within 3 days, and standard PAs within 7 days by January 1, 2026 + **March 31, 2026:** Ensure that the client produces and publicly posts prior authorization metrics; ensure that the client reports the Patient Access API utilization metrics to the Centers for Medicare and Medicaid Services (CMS) + **January 1, 2027:** Ensure that the client adopts the federally mandated APIs by January 1, 2027 (Payer-to-Payer, Provider Access, Prior Authorization) and updates the Patient Access API to include prior authorization data + Furthermore, the PM must coordinate with agency staff and vendors to ensure that the current Patient Access API is accessible to members The candidate must have strong facilitation skills, experience with taking rough ideas and fleshing them into clear business requirements, excellent organizational, time management, and communication skills, and the ability to effectively coordinate resources and to meet deadlines. **DETAILED STATEMENT OF DUTIES AND RESPONSIBILITIES:** + Responsible for the overall success of the project and is the primary point of accountability for the management and implementation of the interoperability final rule project Responsible for overseeing the Project Management vendor supporting the Interoperability& Prior Authorization Initiative This includes ensuring deliverables align with objectives, timelines, and quality standards as outlined in the clients’ contract. Acts as the primary liaison for coordination, performance monitoring, and issue resolution, and provides governance and reporting to project leadership. + Responsible for facilitating the acquisition of resources and the coordination of X-functional activities between its’ business partners, and external entities to effectively implement the interoperability requirements. + Lead workgroup activities and collaborate with approximately 30+ multidisciplinary team members comprised of business and technical staff to ensure effective project execution, communication, and compliance with the federal rule. This includes facilitating discussions to flesh out business and technical requirements. + Develop and manage project plans, timelines, and related activities to ensure the timely completion of project deliverables and the alignment of business needs; adapt to shifting timelines and priorities + Facilitate project team meetings to communicate the status of the project and to coordinate and manage project team activities + Develop presentations, project reports, and other materials to effectively communicate the status of the project, provide regular reports to stakeholders, ensuring transparency and accountability; address key issues and facilitate escalations; this includes research and the identification of recommendations to address the issues. + Monitor risks and issues; develop and implement mitigation strategies and track action items; Maintain detailed project documentation, and track progress through completion + Coordinate with the project team and the project management vendor to facilitate the project team’s review and validation of project deliverables and participation in key project activities (e.g., requirements validation, design documents, etc.). + Support the project’s compliance with downstream federal funding requirements; this includes invoice management, human resource time & attendance reporting, and other related tasks. + Develop and maintain effective relationships with project team members, senior leadership, and stakeholders across the project. + Foster a culture of collaboration, innovation, and continuous improvement within the project team and across relevant stakeholders + Manage stakeholder expectations, resolve conflicts, and facilitate consensus amongst diverse groups with competing priorities + Adhere to established policy and procedures with respect to project management and procurement processes and procedures, and other related standards. **QUALIFICATIONS and EXPERIENCE:** + A minimum of 5 years’ experience managing complex, cross-organizational technology projects within the healthcare industry + Experience managing vendor contracts in the healthcare & information technology industry, including experience working with large healthcare systems (commercial payers, Medicaid, Medicare) + Ability to develop and maintain effective relationships with management, vendors, business and technical project team members; and the ability to translate and communicate technical concepts and information to business staff + Knowledge of the Systems Development Life Cycle (SDLC), Application Programming Interfaces (API), + Bachelor’s degree or equivalent + Ability to document and convey complex concepts in a simple easy to understand manner and format + Experience leading programs/projects with a budget over $1M + Experience leading programs/projects of 20+ staff, including vendor contractors + Demonstrated experience of successfully delivering projects from initialization through operationalization + Excellent communication, presentation, and interpersonal skills, with the ability to effectively collaborate with diverse teams and stakeholders. + Ability to assess priorities and flexibly meet the dynamic needs of the team + Ability to work independently and process quickly, independently, prioritizing work activities + Strong problem-solving skills; experience identifying, analyzing and resolving complex problems through structured processes + Knowledge of healthcare regulations and compliance requirements, such as HIPAA, Medicare, and Medicaid. **PREFERRED EXPERIENCE and SKILLS:** + Expertise in facilitating discussions, resolving conflicts, and fostering productive team engagement + Skilled in eliciting, defining, and formalizing business requirements for complex projects + Ability to clearly articulate project or program needs to accomplish goals + Familiarity with the Massachusetts healthcare landscape, including key healthcare stakeholders such as payers, providers, and consumers + Proficiency with MS Office applications including Excel, Word, Visio, Outlook and PowerPoint. + Project management certification (PMP or equivalent) is a plus, demonstrating a commitment to professional development and industry best practices. . 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