Certification Lead

Essential Duties and Responsibilities:

- Apply business process improvement practices to re-engineer methodologies/principles and business process modernization projects.

- Assist in the application of activity and data modeling, transaction flow analysis, internal control and risk analysis, modern business methods, and performance measurement techniques.

- Assist in establishing standards for information systems procedures.

- Develop solutions to a variety of complex problems.

- Develop and apply organization-wide information models for use in designing and building integrated shared software and database management systems and data warehouses.

- Follow Information Management guiding principles, cost savings, and open system architecture objectives.

- Lead and manage the full CMS certification lifecycle, from planning through approval.
- Develop, implement, and maintain a comprehensive CMS Certification Readiness Plan.

- Create and manage the Certification Plan and supporting documentation.

- Prepare for and support Operational Readiness Reviews (ORR) and Certification Reviews (CR).

- Develop and manage operational and certification metrics in alignment with current CMS guidance.

- Serve as the primary liaison with the state Medicaid agency, CMS, and other stakeholders throughout certification activities.

- Oversee implementation phases to ensure certification readiness and alignment with project plans.

- Facilitate periodic Certification Progress Report cycles and executive-level updates.

- Ensure accurate documentation, audit readiness, and compliance with CMS IT certification standards.

Minimum Requirements

- Bachelor's degree in related field.

- 5-7 years of relevant professional experience required.

- Equivalent combination of education and experience considered in lieu of degree.

- A minimum of 5 years of experience in Medicaid or government healthcare.

- A minimum of 3 years of experience in CMS certification process.

- Demonstrated experience leading CMS certification efforts through full approval.

- Hands-on experience with current CMS IT certification standards and guidance.

- Proven experience supporting IT system implementations for state Medicaid agencies.

- Strong understanding of Medicaid Enterprise Systems and CMS oversight processes.

- Ability to manage complex timelines, deliverables, and cross-functional dependencies.

- Excellent written and verbal communication skills, including executive-level reporting.

Preferred Requirements

- Experience supporting multiple CMS certifications or large-scale public sector IT programs.
- Prior experience working directly with CMS reviewers and state Medicaid leadership.
- Familiarity with Operational Metric Reporting and federal compliance audits.

Home Office Requirements

- Internet speed of 20mbps or higher required (you can test this by going to www.speedtest.net).

- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to t...