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Medicaid Enterprise System Manager

Company: WV Department of Health and Human Resources
Location: Charleston
Posted on: November 18, 2022

Job Description:

Department of Health and Human Resources (DHHR)/Bureau for Medical Services (BMS)/Kanawha County - Under general direction, performs complex administrative and professional work at the advanced level in managing a major program component within the Bureau for Medical Services, Medicaid Enterprise System (MES), Medicaid Management Information System (MMIS) for the Department of Health and Human Resources. This position acts as a liaison between the MMIS vendor, BMS, and other stakeholders and is responsible for the oversight of all aspects of system operations and is critical to ensuring WV Medicaid claims are paid timely and accurately. Responsibilities include facilitating meetings to ensure accurate requirements are gathered for change requests, reporting needs, data requests, and major and minor projects, as well as system configuration and implementation. Meetings may include BMS, MES/MMIS vendors, CMS, the Cabinet Secretary's office, DHHR Finance, and/or a variety of others. Oversight, track, document, and manage the Change Management process within MMIS by gathering analyzing, System Integration Testing, (SIT), User Acceptance Testing (UAT), and production testing, reviewing, inventorying, and approving any change requests, including changes in configuration, rate setting, policy changes, data requests, data analysis, projects, issues, defects, and upgrades to the MMIS. Negotiate approvals and denials of due date extensions. Review, monitor, manage, and oversee changes, enhancements, and planned projects as needed for BMS to ensure contractual compliance. Review the MMIS access forms to ensure the access requested is valid and needed and grant access to the MMIS. Quarterly access review and audit to validate appropriate user access. Provide education and technical support for MMIS with access/technology issues including tracking resolution and communicating resolution with affected users. Assist with claims issues as needed. Supervision of assigned employees to assist with Operations duties. Provide training for employees. Assign and delegate duties. Monitor and provide administrative direction and oversight. Approve timesheets/leave requests. Conduct EPAs. Performs other duties and related work as assigned. #DHHRJOBS
Minimum QualificationsTraining: Master's degree from an accredited college or university in the area of assignment.Substitution: One year of full-time or equivalent part-time paid experience as described below may substitute for the Master's degree. Experience: Three years of full-time or equivalent part-time paid professional experience in the area of assignment, one year of which must have been in a program administration capacity.Substitution: Post-graduate training in the area of assignment may substitute through an established formula for the non-supervisory experience.

Keywords: WV Department of Health and Human Resources, Charleston , Medicaid Enterprise System Manager, Executive , Charleston, West Virginia

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