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Medical Services System Modernization Manager

State of South Dakota
Sioux Falls, SD Full Time
POSTED ON 2/6/2025
AVAILABLE BEFORE 3/7/2025
PLEASE ATTACH THE ADDITIONAL REQUIREMENTS LISTED AT THE BOTTOM OF THIS PAGE

Job ID: 30308

Agency: Department of Social Services, Division of Medical Services

Location:Pierre or Sioux Falls, SD

Salary: $71,764.56-$107,640.58 Annual Salary, depending on qualifications

Pay Grade: L

Closing Date: Open Until Filled

This is a Full-Time 40 Hour Weekly position with the Department of Social Services. For more information on the Department of Social Services, please visit https://dss.sd.gov/ .

The Medical Services Division within the Department of Social Services is hiring a System Modernization Manager to join its leadership team. This role will coordinate and facilitate system changes and enhancements to South Dakota’s Medicaid Management Information Systems (MMIS) and related enterprise system tools. The Modernization Manager will serve as a primary liaison with CMS related to our MMIS operations, system performance reviews and preparation and submission of all advance planning documents required for securing federal funding. This position will provide direction to a small team that includes business implementation leads and business analysts working on system projects. This individual will use their strong communication and project management skills to advance change in the backbone systems that manage Medicaid claims payment and related functions.

Our System Modernization manager will ensure strong collaboration with the Bureau of Information and Telecommunications (BIT) teams, as well as across various state agencies and divisions who are all part of the Medicaid program. They will lead procurement and certification activities for vendors selected to assist with modernization activity and manage related vendor relationships and contracts.

The Ideal Candidate Will Have

Extensive experience in healthcare information system or Medicaid management or health plan information systems including claims adjudication and payment, care management and prior authorization and provider management functions. Experience with procurements, system development life cycle, and large-scale system implementations. Significant experience leading a team. Project management, communication, analytical skills. The ability to maintain relationships with CMS system contacts, and technology vendors. The ideal candidate will be comfortable taking initiative and leading initiatives.

Knowledge, Skills, And Abilities

Knowledge of

  • Medicaid or health payer claims and billing systems, population health and reporting systems
  • Project Management principles, including project cost and budgeting
  • Vendor procurement and contracting
  • Business Analysis, requirement documentation, and system development life cycle

Skill to

  • manage interdependent, complex system changes
  • translate technical issues to updates that are clear, relevant and timely for multiple audiences;
  • Analyze and present options to senior leadership
  • lead both direct and indirect reports involved in technology project teams
  • facilitate transitions to new information systems and process through change management strategies

Ability to

  • communicate complex processes concisely and clearly;
  • establish and maintain effective working relationships with others;
  • successfully coordinate internal and external stakeholders and activities that enable the division's implementation of new IT systems
  • troubleshoot IT issues including those arising from claims payment and implementation of new systems
  • develop, analyze, and convey analytical reports regarding program demographics, expenditures, and performance metrics.

Additional Requirements: To be considered, please attach your resume.

This position is exempt from the Civil Service Act.

This position is eligible for Veterans’ Preference per ARSD 55:10:02:08.

The State of South Dakota does not sponsor work visas for new or existing employees. All persons hired will be required to verify identity and eligibility to work in the United States and complete an Employment Eligibility Verification, Form I-9. The State of South Dakota as an employer will be using E-Verify to complete employment eligibility verification upon hire.

The State of South Dakota offers $0 premium employee health insurance option plus eleven paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at https://bhr.sd.gov/job-seekers/work-for-state-government/ . This position is a member of Class A retirement under SDRS.

Must apply online: https://gen-stateofsouthdako-trn.inforcloudsuite.com/hcm/xmlhttp/shorturl.do?key=14I

You must apply online, emailed resumes or submissions will not be accepted.

South Dakota Bureau of Human Resources

Telephone: 605.773.3148 Email: careers@state.sd.us

http://bhr.sd.gov/workforus

"An Equal Opportunity Employer"

Salary : $71,765 - $107,641

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