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.
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Professional Management Enterprises
Dec 03, 2025