MEDICAID MANAGEMENT INFORMATION SYSTEMS OPERATIONS MANAGER

Augusta, Maine, United States Full-time

Application closes: Dec. 13, 2019
Asst. Div. Director Medicaid/Medicare Services
Opening Date: December 2, 2019

Closing Date:  December 13, 2019

Job Class Code: 4204
Grade: 28
Salary: $52,499.20 – $72,196.80 /yr.
Position Number: 02000-2106

 

Agency information:

The Department of Health and Human Services (DHHS) provides supportive, preventive, protective, public health and intervention services that safeguard the public health and assist families and individuals to meet their needs. DHHS strives to provide these programs and services while respecting the rights and preferences of individuals and families. The Office of MaineCare Services (OMS) within DHHS administers the state’s Medicaid program and coordinates several major healthcare financing programs for Maine, including the Children’s Health Insurance Program (CHIP). OMS works collaboratively with the Commissioner’s Office of DHHS and the Office of the Governor on health reform and coordinates with other health plans on statewide healthcare improvement initiatives. OMS ensures that the healthcare programs and services it administers operate in alignment with DHHS goals and federal mandates and are consistent with State policy. OMS also provides oversight necessary to ensure accountability and efficient and effective administration.

 

The Medicaid Management Information System (MMIS) Operations team is responsible for defining and adopting strategies, structures, procedures, and technologies to respond to  changes in and around the Department’s MMIS, a large technology platform through which healthcare providers enroll with MaineCare, submit claims, and are reimbursed for the MaineCare-covered services they provide. MMIS operations activities include the management of technology enhancements, updates, fixes, and action items. Technology changes may stem from State and Federal regulations, policies, and rules; strategic and operational needs; and technical defects.

Job duties:

 As the MMIS Operations Manager, you will be responsible for oversight of day-to-day MMIS operations activities undertaken by OMS and by the Department’s contracted fiscal agent, who is responsible for maintaining and operating the MMIS. You will ensure that the Department and the fiscal agent meet Federal and State requirements, contribute to workplan development, and align the team to OMS and Department business needs and priorities. You will coordinate regular and ad-hoc information-sharing with other OMS teams (including Policy, Provider Relations, Health Care Management, Value-Based Purchasing, Transportation, and Pharmacy) to identify needed changes and agree upon implementation approaches and schedules. Your work will include a focus on internal performance measures, evaluating processes for efficiency and effectiveness, and ensuring appropriate communication within and across teams. Work is performed under minimal supervision.

 

Regular duties include:

  • Supervising the MMIS Operations and User Acceptance Testing teams to ensure that work is appropriately prioritized, scheduled, and executed according to established workplans and deadlines;
  • Working closely with the MMIS Project Manager and the fiscal agent to ensure that MMIS changes such as enhancements and defect resolutions are designed, developed, tested, and implemented in accordance with established policies and procedures and are completed according to established workplans, deadlines, and budgets;
  • Working closely with other OMS teams (including directors, managers, and supervisors), the fiscal agent, other vendors, and provider/member representatives to gather business requirements, conduct research, assess and report on the status of MMIS operations activities, and communicate changes to appropriate stakeholders;
  • Reviewing and approving work and contract-related deliverables to ensure they are complete, accurate, and meet requirements;
  • Providing direction on escalated issues, questions, and decisions;
  • Providing recommendations to OMS Leadership on resolution of system defects and operational issues, prioritization of tasks, and approaches to address system enhancements and updates; and
  • Collaborating with other Department or State teams as needed on cross-agency or cross-Department initiatives.

 

This position reports to the OMS Chief Operating Officer.

MINIMUM QUALIFICATIONS:

 

A Bachelor’s Degree in Health or Hospital Administration, or a field related to technology or project management, and four (4) years’ professional experience in medical administrationand/or health care administration and/or application-related IT experience and/or project management, including three (3) years in a supervisory capacity. Experience may be substituted for education.

 

The background of well-qualified candidates will demonstrate the following competencies. Please address these competencies in your cover letter:

 

  1. Experience managing projects through the Software Development Life Cycle, including knowledge of change management processes, practices, and tools and the ability to read, understand, and interpret technical documentation;
  2. Exceptional leadership skills and a proven ability to direct and oversee the work of staff while building relationships and motivating others;
  3. Proven record of success in project management, preferably within a large technology project, with a focus on establishing quality standards, improving the efficiency and effectiveness of workflows, tracking results, and evaluating outcomes; 
  4. Significant experience facilitating communications with and amongst internal and external stakeholders, and the ability to work effectively with health care consumers and providers; and
  5. Ability to develop a working knowledge of data systems and applications and to comprehend, analyze, and manage complex data.

APPLICATION INFORMATION:

To apply, please upload a resume and cover letter. To request a paper application, please contact Ashley Smith at  Ashley.Smith@maine.gov .

BENEFITS
Value of State’s share of Employee’s Retirement: 14.47% of pay   
Value of State-paid Dental Insurance:  $14.31 biweekly

Value of State-paid Health Insurance*:

Level 1:  100% State Contribution = $461.75 biweekly (employee pays nothing)
Level 2:  95% State Contribution = $438.66 biweekly (Employee pays: 5%)
Level 3:  90% State Contribution = $415.58 biweekly (Employee pays: 10%)
Level 4:  85% State Contribution = $392.49 biweekly (Employee pays: 15%)
*The level of actual value of state paid Health Insurance will be based on employee’s wage rate and status with regard to the health credit premium program as of July 1, 2019.

 

The Department of Health and Human Services is an Equal Opportunity/Affirmative Action employer.  We provide reasonable accommodations to qualified individuals with disabilities upon request.