Senior Program Manager

Required Education:
Bachelors or Graduate degree in relevant field (e.g. Computer Science Engineering Science Healthcare Management Public Health Business Administration or Health Policy) or equivalent experience

Preferred Certification:
Project Management Professional (PMP) Certification

Required Skills and Experience:
5-7 years of experience in program and project management preferably in 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 budget over $1M
Experience leading programs/projects of 20 staff including vendor contractors
Demonstrated track record of delivering technical programs through 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 Skills and Experience:
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 Massachusetts health care landscape including key healthcare stakeholders
such as payers providers and consumer representatives

Client is seeking a highly skilled and experienced candidate to fill the Standardized Encounter Data Program (SENDPRO) Senior Program Manager (PM) position. Client is the single state agency responsible for administering the Commonwealths Medicaid program and its Childrens Health Insurance Program (together Client). Client provides health coverage services to qualifying members including families disabled individuals children long-term unemployed adults and seniors through a variety of programs including fee-for-service and managed care and related programs. Client contracts with Managed Care Entities (MCEs) that submit information describing services received by Client 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 Clients encounter data needs.

Reporting to Clients 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 agencys commitment to proactively improve data quality and increase completeness and compliance. You will participate 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.

Duties and 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 agencys 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 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 Clients program administration requirements
Prepare program/project status reports for Executive Steering Committee and external reporting including CMS (Centers for Medicare & Medicaid Services)
Manage financial processes for MassHealth projects; provide updates for Leadership and the Annual IT Capital process