CMS Certification Manager

Overview

The CMS Certification Manager will lead compliance and certification processes to ensure the HCMACS Program’s Enterprise EHR Solution meets all Centers for Medicare & Medicaid Services (CMS) standards. This role involves acting as the primary liaison with federal agencies, analyzing federal certification frameworks, and ensuring all deliverables, testing results, and system requirements meet established guidelines. The CMS Certification Manager will play a key role in aligning program outcomes with Medicaid Enterprise Certification Toolkit (MECT) and Streamlined Modular Certification (SMC) requirements, contributing directly to Medicaid initiatives and federal compliance goals.

This position performs all duties and responsibilities in accordance with the Mission, Vision, and Core Values of Cayuse.

Responsibilities

• Creates a comprehensive plan that outlines the timeline, milestones, and key deliverables for the CMS certification process.
• Acts as the primary point of contact between HCMACS, CMS, and other federal entities.
• Analyzes CMS regulations, guidance, and checklists to ensure the project aligns with federal standards, including the Medicaid Enterprise Certification Toolkit (MECT) or Streamlined Modular Certification (SMC).
• Ensures all required documentation, including project management artifacts, system requirements, testing results, and performance metrics, are prepared and submitted according to CMS guidelines.
• Verifies that the system complies with relevant federal policies, including the Medicaid Information Technology Architecture (MITA) framework and security protocols.
• Addresses feedback or findings from CMS during certification reviews and audits.
• Develop, implement, and manage a detailed CMS certification plan, including timelines, milestones, required documentation, and communication strategies.
• Act as the primary point of contact between the HCMACS Program team, CMS, and other federal entities to ensure certification alignment and resolve inquiries.
• Analyze CMS regulations, including the Medicaid Enterprise Certification Toolkit (MECT) and Streamlined Modular Certification (SMC), to ensure compliance with federal standards.
• Prepare, organize, and submit the artifacts required for certification, such as system design requirements, testing results, performance metrics, and benefits realization matrices.
• Ensure adherence to Medicaid Information Technology Architecture (MITA) and federal security protocols, including HIPAA compliance and data security provisions.
• Assemble required documentation for audits and ensure compliance with CMS reviews, responding to findings with corrective action plans as needed.
• Collaborate with the Program Management Office (PMO) to align certification deliverables with project schedules and milestones.
• Conduct internal readiness assessments to validate the program’s compliance with CMS requirements and proactively recommend changes or updates as necessary.
• Facilitate workshops, meetings, and briefings with governance bodies, stakeholders, and HCMACS leadership on certification progress, risks, and updates.
• Stay current on CMS policy revisions and reflect updates in the certification approach to ensure ongoing compliance.
• Oversee validation of system compliance with federal accreditation standards, ensuring all functional and technical requirements are met before submissions.
• Work closely with the Systems Integrator (SI) to ensure technical and architectural deliverables align with CMS requirements and are certified before go-live.
• Knowledge of Medicaid Information Technology Architecture (MITA) compliance standards.
• Other duties as assigned.

Qualifications

• Bachelor’s degree in Healthcare Administration, Information Technology, Project Management, or a related field.
• Minimum of five (5) years of relevant experience with CMS certification processes, including expertise with the Medicaid Enterprise Certification Toolkit (MECT) and Streamlined Modular Certification (SMC).
• Demonstrated experience in federal compliance management and documentation submission for large-scale IT healthcare or Medicaid-related projects.
• Proven ability to interpret and apply CMS regulations and guidelines within the context of complex IT or enterprise projects.
• Demonstrated experience with Project Management and Compliance in Government IT projects.
• Demonstrated proficiency in interpreting federal guidelines and managing stakeholder relationships.
• Must be able to pass a background check. May require additional background checks as required by projects and/or clients at any time during employment.

Minimum Skills:

• Proven ability to