Project Manager-Senior

JOB TITLE: Project Manager Senior
JOB LOCATION: Quincy MA
WAGE RANGE*: $65-$70
JOB NUMBER: ITS77_EHS_FY25_PRO MAN - 800 - PAI117.75 #3

REQUIRED 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.

JOB DESCRIPTION

The Interoperability 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 across MassHealth. 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 to ensure that MassHealth meets critical milestones in 2026 and 2027.

This includes, but is not limited to:

• January 1, 2026: Ensure that MassHealth adjudicates urgent Prior Authorization (PA) requests within 3 days, and standard Client within 7 days by January 1, 2026

• March 31, 2026: Ensure that MassHealth produces and publicly posts prior authorization metrics; ensure that MassHealth reports the Patient Access API utilization metrics to the Centers for Medicare and Medicaid Services (CMS)

• January 1, 2027: Ensure that MassHealth 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 MassHealth members

The candidate must have 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
• Manage all activities of the interoperability planning vendor to ensure the timely delivery of services as defined in the contract executed; support vendor procurement activities to acquire an implementation vendor
• Lead 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.
• 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.

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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