Company:
Mindlance
Location: Quincy
Closing Date: 04/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
Overview: Standardized Encounter Data Program
The client is seeking a highly skilled and experienced candidate to fill the Standardized Encounter Data Program (SENDPRO) Senior Program Manager (PM) position. The client contracts with Managed Care Entities (MCEs) that submit information describing services received by members administered by the MCE, including payments made by the MCE to providers that performed the services defined as encounter data. Encounter data is leveraged for many critical business processes including program integrity, rate development, CMS reporting, contract management, and health equity initiatives. The Standardized Encounter Data Program (SENDPRO) is the Medicaid IT initiative to migrate the process of collecting encounter data from the legacy file format to a standard Electronic Data Interchange (EDI) X12 837 Post Adjudicated Claims Data Reporting (PACDR) and National Council for Prescription Drug Programs (NCPDP) Post Adjudication Standard format for Medical and Pharmacy Medicaid encounters respectively. The 837 and NCPDP PACDR is the official standard tailored to support post-adjudicated claims and best supports encounter data needs.
Reporting to the Director of Enterprise Data Management and Engineering (EDME), as the Senior Program Manager, you will be responsible for leading SENDPRO. You will manage and oversee workstreams including internal development, testing, vendor management, and Managed Care Entity (MCE) communications. You and the SENDPRO Program Team will deliver implementation of the EDI solution, maintain continuity of operations during cutover from the legacy system, and ensure SENDPRO meets its objectives to improve Encounter Data quality and enhance Managed Care Entity performance management. This position is aligned with the agency s commitment to proactively improve data quality and increase completeness and compliance. You will participate in and lead a high-visibility technology initiative, providing escalation management, assessing risks, anticipating bottlenecks, and balancing business needs against technical constraints. This will be a hybrid role requiring the candidate to be comfortable with both program management and project management duties.
Responsibilities:
Serve as the Senior Program/Project Manager; coordinate tasks, workgroups, and deliverables amongst SENDPRO team members and stakeholders.
Define and execute program/project goals, priorities, and performance metrics, to ensure alignment with the agency's priorities.
Support all phases of release management and implementation, including design, development, testing, and deployment.
Manage external vendors/system implementors to hold them accountable for their service delivery.
Use program/project management best practices, methodologies, and tools to achieve program/project objectives and drive efficiency.
Manage timelines for deliverables based on deadlines negotiated with program/project stakeholders.
Led program governance structures to inform, strategize, and confirm decisions.
Prepare and deliver briefings to executives, including change requests for scope, timeline, and/or cost. Identify program risks, issues, and dependencies; develop and execute mitigation plans.
Monitor program performance including vendor performance, contract management, milestone tracking, and financial cost management.
Lead 25+ team members, including business, technical, and vendor staff.
Foster a culture of collaboration, innovation, and continuous improvement within the SENDPRO team and across relevant stakeholders.
Adapt to shifting priorities and timelines.
Engage with key stakeholders to understand their needs and ensure their alignment with program/project objectives.
Manage stakeholder expectations, resolve conflicts, and facilitate consensus among diverse groups with competing priorities.
Complete activities to ensure compliance with program administration requirements.
Prepare program/project status reports for the Executive Steering Committee and external reporting, including CMS (Centers for Medicare & Medicaid Services).
Manage financial processes for projects; provide updates for Leadership and the Annual IT Capital process.
QUALIFICATIONS: Minimum experience/skills:
Bachelor's or Graduate degree in a relevant field (e.g., Computer Science, Engineering, Science, Healthcare Management, Public Health, Business Administration, or Health Policy) or equivalent experience.
5-7 years of experience in program and project management, preferably in a healthcare or financial services setting.
5-7 years of experience in leading complex, technical, cross-organizational programs and/or projects, including data warehousing, data transformation, analytics, and systems integration.
Experience leading programs/projects with a budget of over $1M.
Experience leading programs/projects of 20+ staff, including vendor contractors.
Demonstrated track record of delivering technical programs through the Software Development Lifecycle, from initialization to operationalization.
Demonstrated experience utilizing project management principles and practices.
Strong problem-solving skills; experience identifying, analyzing, and resolving complex problems through structured processes.
Proven ability to communicate effectively with both business and technical stakeholders
Proven ability to lead effective meetings and work sessions, with all levels of staff and leadership.
Knowledge of Microsoft Office Suite of Products (Word, PowerPoint, Excel, Project). Preferred experience/skills:
Familiarity with agile principles and practices along with experience in working in an agile environment and strong understanding of the Software Development Lifecycle.
Familiarity with Medicaid Encounter Data and T-MSIS (Transformed Medicaid Statistical Information System).
Ability to clearly articulate project or program needs to accomplish goals.
Strong customer service orientation with the ability to understand customer needs.
Strong relationship-building capabilities with a focus on partnership.
Comfortable with ambiguity and conflicting information.
Familiarity with projects involving cloud platforms.
Experience working in a government healthcare agency, other public sector environment, health plan, or provider settings.
Familiarity with the healthcare landscape, including key healthcare stakeholders such as payers, providers, and consumer representatives.
Project Management Professional (PMP) Certification.
The client is seeking a highly skilled and experienced candidate to fill the Standardized Encounter Data Program (SENDPRO) Senior Program Manager (PM) position. The client contracts with Managed Care Entities (MCEs) that submit information describing services received by members administered by the MCE, including payments made by the MCE to providers that performed the services defined as encounter data. Encounter data is leveraged for many critical business processes including program integrity, rate development, CMS reporting, contract management, and health equity initiatives. The Standardized Encounter Data Program (SENDPRO) is the Medicaid IT initiative to migrate the process of collecting encounter data from the legacy file format to a standard Electronic Data Interchange (EDI) X12 837 Post Adjudicated Claims Data Reporting (PACDR) and National Council for Prescription Drug Programs (NCPDP) Post Adjudication Standard format for Medical and Pharmacy Medicaid encounters respectively. The 837 and NCPDP PACDR is the official standard tailored to support post-adjudicated claims and best supports encounter data needs.
Reporting to the Director of Enterprise Data Management and Engineering (EDME), as the Senior Program Manager, you will be responsible for leading SENDPRO. You will manage and oversee workstreams including internal development, testing, vendor management, and Managed Care Entity (MCE) communications. You and the SENDPRO Program Team will deliver implementation of the EDI solution, maintain continuity of operations during cutover from the legacy system, and ensure SENDPRO meets its objectives to improve Encounter Data quality and enhance Managed Care Entity performance management. This position is aligned with the agency s commitment to proactively improve data quality and increase completeness and compliance. You will participate in and lead a high-visibility technology initiative, providing escalation management, assessing risks, anticipating bottlenecks, and balancing business needs against technical constraints. This will be a hybrid role requiring the candidate to be comfortable with both program management and project management duties.
Responsibilities:
Serve as the Senior Program/Project Manager; coordinate tasks, workgroups, and deliverables amongst SENDPRO team members and stakeholders.
Define and execute program/project goals, priorities, and performance metrics, to ensure alignment with the agency's priorities.
Support all phases of release management and implementation, including design, development, testing, and deployment.
Manage external vendors/system implementors to hold them accountable for their service delivery.
Use program/project management best practices, methodologies, and tools to achieve program/project objectives and drive efficiency.
Manage timelines for deliverables based on deadlines negotiated with program/project stakeholders.
Led program governance structures to inform, strategize, and confirm decisions.
Prepare and deliver briefings to executives, including change requests for scope, timeline, and/or cost. Identify program risks, issues, and dependencies; develop and execute mitigation plans.
Monitor program performance including vendor performance, contract management, milestone tracking, and financial cost management.
Lead 25+ team members, including business, technical, and vendor staff.
Foster a culture of collaboration, innovation, and continuous improvement within the SENDPRO team and across relevant stakeholders.
Adapt to shifting priorities and timelines.
Engage with key stakeholders to understand their needs and ensure their alignment with program/project objectives.
Manage stakeholder expectations, resolve conflicts, and facilitate consensus among diverse groups with competing priorities.
Complete activities to ensure compliance with program administration requirements.
Prepare program/project status reports for the Executive Steering Committee and external reporting, including CMS (Centers for Medicare & Medicaid Services).
Manage financial processes for projects; provide updates for Leadership and the Annual IT Capital process.
QUALIFICATIONS: Minimum experience/skills:
Bachelor's or Graduate degree in a relevant field (e.g., Computer Science, Engineering, Science, Healthcare Management, Public Health, Business Administration, or Health Policy) or equivalent experience.
5-7 years of experience in program and project management, preferably in a healthcare or financial services setting.
5-7 years of experience in leading complex, technical, cross-organizational programs and/or projects, including data warehousing, data transformation, analytics, and systems integration.
Experience leading programs/projects with a budget of over $1M.
Experience leading programs/projects of 20+ staff, including vendor contractors.
Demonstrated track record of delivering technical programs through the Software Development Lifecycle, from initialization to operationalization.
Demonstrated experience utilizing project management principles and practices.
Strong problem-solving skills; experience identifying, analyzing, and resolving complex problems through structured processes.
Proven ability to communicate effectively with both business and technical stakeholders
Proven ability to lead effective meetings and work sessions, with all levels of staff and leadership.
Knowledge of Microsoft Office Suite of Products (Word, PowerPoint, Excel, Project). Preferred experience/skills:
Familiarity with agile principles and practices along with experience in working in an agile environment and strong understanding of the Software Development Lifecycle.
Familiarity with Medicaid Encounter Data and T-MSIS (Transformed Medicaid Statistical Information System).
Ability to clearly articulate project or program needs to accomplish goals.
Strong customer service orientation with the ability to understand customer needs.
Strong relationship-building capabilities with a focus on partnership.
Comfortable with ambiguity and conflicting information.
Familiarity with projects involving cloud platforms.
Experience working in a government healthcare agency, other public sector environment, health plan, or provider settings.
Familiarity with the healthcare landscape, including key healthcare stakeholders such as payers, providers, and consumer representatives.
Project Management Professional (PMP) Certification.
Share this job