Job Description

Job Title: Healthcare IT Project Manager

Location: Nashville, TN/Remote (U.S.)
Employment Type: Full-time
Hours: Standard business hours (9am-5pm local time), with flexibility for critical deadlines

Job Description

Overview

We are seeking an experienced Healthcare IT Project Manager to lead complex, multi-vendor initiatives within Medicaid Enterprise Systems (MES). The ideal candidate brings deep subject matter expertise in Medicaid, Healthcare EDI, and SDLC methodologies-combined with exceptional communication and project leadership skills. This role requires the ability to drive outcomes, proactively manage risks, and coordinate with clients, vendors, and internal technical teams in a fast-paced environment.

Key Responsibilities

• Client & Vendor Leadership:

• Lead client-facing and cross-vendor meetings with confidence and clarity.

• Develop agendas, facilitate discussions, document decisions, and ensure follow-through on action items.

• Professionally challenge or push back on vendors when needed to protect scope, timeline, and quality.

• Project & Delivery Management:

• Manage end-to-end project activities, including planning, requirements analysis, risk mitigation, and delivery.

• Ensure timely execution and responsiveness for urgent project issues, escalations, and client emails.

• Oversee workstreams across technical and business domains related to MES modules, data integrations, and system enhancements.

• Medicaid & EDI Expertise:

• Apply strong working knowledge of Medicaid Enterprise Systems, CMS regulations, claims processing, medical terminology, and billing operations.

• Work extensively with healthcare EDI transactions (e.g., 834, 820, 837I/P/D, 835, NCPDP).

• Collaborate with internal teams to validate technical solutions aligned with regulatory and business requirements.

• SDLC & Process Execution:

• Apply industry-standard project management methodologies (PMBOK, Agile, hybrid).

• Ensure documentation, testing cycles, and deployments follow established SDLC processes.

• Drive continuous improvement across project workflows and team coordination.

  Required Qualifications

  • Strong verbal and written communication skills with the ability to influence and lead both clients and vendors.

  • Demonstrated experience delivering complex projects under tight deadlines.

  • Extensive background in Medicaid and Medicaid Enterprise Systems (MES) .

  • Solid understanding of healthcare EDI/X12 standards (834, 820, 837I, 837P, 837D, NCPDP, 835).

  • Experience in Healthcare IT , system integration , and the software development life cycle .

  • Hands-on experience with project management frameworks such as PMI/PMBOK or Agile.

  • PMP certification (or equivalent) strongly preferred.

  • Availability to work standard business hours (9am-5pm) with flexibility around critical deadlines.

  Preferred Qualifications

  • Experience managing multi-state or large-scale Medicaid IT implementations.

  • Background working with MMIS/MES vendors, state agencies, and multi-disciplinary technical teams.

  • Familiarity with CMS modularity standards or certification requirements.

  • Ability to translate between technical and business stakeholders.

Job Tags

Similar Jobs