Medicaid Oversight Project Manager

HCH Enterprises is seeking an Oversight Project Manager to provide management support to the RI Medicaid – Managed Care Organization (MCO), administered by the Executive Office of Health and Human Services (EOHHS). The project manager will assist the State in the oversight of the Managed Care organization in various capacity, including:

o All contractual requirements

o Quality

o Compliance

o Financial

o Operational performance

Overall Responsibilities:

• Provide project management support and expertise for the development of EOHHS Managed Care Policy and Procedures manual to align all governing policies internally and for MCOs; develop and design internal and external policies as requested for EOHHS.

• Serve as Project Management Lead for the rollout of mandatory MCO reporting to EOHHS; provide technical assistance in policy design and development for internal oversight and for contracts.

• Serves as Project Manager for Monthly Core Contract Oversight meetings; organize and plan for Managed Care monthly meeting contract oversight with key EOHHS personnel.

• Coordinate internal contract oversight meetings for Rhode Island’s Medicaid Managed Care core contract and ensure compliance requirements are met for EOHHS through contract alignment to federal, state, and administrative regulations.

• Oversee strategic policy communications for the Medicaid agency to stakeholders for various Health System Transformation projects.

• Provides stakeholder engagement through hosting public meetings for feedback on CMS AE Requirement Documents.

Basic Qualifications:

• Bachelor’s Degree with at least 5 years of relevant professional experience.
• Experience working within the healthcare field.
• Extensive experience and working knowledge of Medicaid/Medicare is preferred.
• PMP certification is preferred but not required.
• Master’s Degree is a plus.

Company Overview:

HCH Enterprises, LLC (HCH) is an IT Consulting, Engineering and Technical Services Company. Founded in 1986 HCH was incorporated in Rhode Island in 2001. Our mission is to develop and deliver high-value, creative and competitive solutions and services to our government and commercial clients. HCH specializes in: Business Analysis; Project/Program Management; Enterprise Architecture; Network Infrastructure Support; System Security; Software and Database Services; and COOP and Disaster Recovery. Our project teams have been providing direct and ongoing technical services and management support in health care and health care transformation efforts in the state of Rhode Island. We are committed to helping our client deliver quality healthcare services to the people they serve.

Job Types: Full-time, Contract

Experience:

• Contract Management: 5 years (Preferred)
• Medicare/Medicaid: 5 years (Required)
• CMS Compliance: 5 years (Preferred)
• Project Management: 5 years (Required)
• Managed Care: 5 years (Required)

Education:

• Bachelor’s (Required)

Location:

• Cranston, RI (Required)

Work authorization:

• United States (Required)

Contract Renewal:

• Likely

Full Time Opportunity:

• Yes

Additional Compensation:

• Bonuses

Work Location:

• One location

Benefits:

• Health insurance
• Dental insurance
• Vision insurance
• Retirement plan
• Paid time off
• Parental leave
• Professional development assistance

Schedule::

• Monday to Friday