Project Manager - Flowood, United States - CapB InfoteK

Description

For one of our long-term multiyear projects, we are looking a Project Manager for the implementation of a cloud-based Software as a Service (SaaS) Enterprise Master Person Index (EMPI The EMPI will be used by DOM to maintain accurate identity management (Medicaid beneficiary identity data) across the DOM enterprise.

Medicaid beneficiary identity data can include Medicaid ID, name, gender, date of birth, race, ethnicity, social security number, current address, contact information, and insurance information.

The Centers for Medicare and Medicaid Services (CMS) has mandated the Medicaid Information Technology Architecture (MITA) strategic vision for all State Medicaid Agencies.

A core component of the MITA vision and framework is the collection, aggregation, and utilization of Medicaid beneficiary clinical data by State Medicaid Agencies.

This Medicaid beneficiary clinical data will come primarily from clinical systems such as Electronic Health Records (EHRs) via interfaces to external stakeholders such as Medicaid providers, the Coordinated Care Organizations (CCOs) and the State of Mississippis Health Information Network, MS-HIN.

The Division of Medicaid (DOM) is implementing an Agency-wide Enterprise Master Person Index, or EMPI, the EMPI will provide new Medicaid identity management services for DOM to programs including the Medicaid Enterprise System (MES) / Medicaid Replacement Project (MRP), provide identity management in partnership with the Mississippi Department of Human Services (MDHS) for the DOM MDHS Health and Human Services Transformation Project (HHSTP), as well as support other DOM Agency programs and systems with identity management services including the existing Clinical Data Interoperability Program (CDIP) EMPI.

The new, Agency-wide DOM EMPI will provide a source of truth for Medicaid beneficiaries, and allow multiple, disparate DOM programs, systems and services, and the DOM-MDHS HHSTP, to access and validate Medicaid beneficiary identities in real-time.

DOMs multiple systems contribute to duplicate identities across the agency, which causes challenges as there is no single source of truth for identities.

With the implementation of the EMPI solution, DOM expects each Medicaid beneficiary to be assigned a unique identifier, so they are represented only once across multiple DOM systems.

Below is a description of two of DOMs major projects that must be addressed by the initial EMPI solution.

Health and Human Services Transformation Project (HHSTP):

In April 2017, the Mississippi State Legislature passed HB 1090, also known as the Medicaid and Human Services Transparency and Fraud Prevention Act or the Hope Act, that mandated comprehensive fraud and abuse measures for both DOM and Mississippi Department of Human Services (MDHS) to implement over several years.

One of the components of the Hope Act was the development of a real-time eligibility verification service to be used by both agencies to improve program integrity.

DOM and MDHS make up two of the key agencies in the Health and Human Services environment and jointly provide services to many of the same Mississippians.

Currently, the State provides access to quality health care for over 720,000 of 2.9 million Mississippians and provides Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits to approximately 460,000 recipients (also known as clients, beneficiaries, or members Crossover between the two agencies is estimated at 65%.

The leadership of both agencies is committed to partnering together to improve services, coordination, and lower cost for the State.

The Health and Human Services Transformation Project (HHSTP) was established with a goal to develop an interoperable Health and Human Services model that provides coordinated client services, reduces fraud and abuse, achieves greater administrative efficiency, promotes self-sufficiency, and introduces innovation to improve the lives of Mississippians served by DOM and MDHS.

DOM and MDHS developed a joint roadmap to implement a series of modules to accomplish the vision of HHSTP and comply with the provisions of the Hope Act.

The existing DOM Enterprise Service Bus (ESB), provided by DXC Corporation, provides the foundation of a modular design and development services infrastructure for HHSTP.

All modules implemented between the two agencies shall utilize the DOM ESB for real-time and standards-based connectivity.

Common Web Portal (CWP): The CWP is the first module and the cornerstone of the interoperable HHSTP.

The CWP is a collaborative streamlined eligibility application that will allow Mississippians to apply for Medicaid, Children's Health Insurance Program (CHIP), SNAP, TANF, Low-Income Home Energy Assistance Program (LIHEAP) and other social services programs in a centralized web portal.

The CWP vision includes robust self-service capabilities for clients to manage their benefits, check on eligibility status, upload documents, and make changes to client information without coming into the regional office.

Fraud and Abuse Module (FAM): The FAM will provide a common fraud and abuse platform that shall perform enhanced eligibility verification, identity authentication and verification, and asset verification.

This module is currently in development.

Enterprise Master Person Index (EMPI): The Enterprise Master Person Index will be a system that connects all clients between each participating agencys eligibility system(s It is to be considered the source of truth for all clients for all programs managed by the participating agencies.

DOM expects the Vendor to propose an enterprise person index solution that links and reconciles records in real-time across DOMs and other state agencies diverse systems.

DOM Clinical Data Interoperability Project (CDIP):

CDIP allows DOM to send and receive clinical data (C-CDAs) through real-time clinical data transactions with Provider Health System Electronic Health Records (EHRs), known as Trading Partners, which include: The University of Mississippi Medical Center, Hattiesburg Clinic, Forest General Hospital, Singing River Health Systems, and Baptist Medical Systems (February 2020); as well as the three Medicaid Managed Care Organizations, throughout the State.

The existing CDIP system, implemented in 2015, contains an Master Person Index (MPI) that is responsible for validating active Medicaid beneficiaries.

The current CDIP MPI contains over 700,000 active Medicaid identities, 2.4 million historical Medicaid identities, and services approximately 30,000 real-time clinical data transactions daily with Medicaid Trading Partners and Managed Care Organizations (MCO Re-procurement of the CDIP is currently in progress. It is DOMs expectation that the proposed DOM EMPI will validate and return beneficiaries for the new CDIP solution.

Summary

The EMPI solution will act as a centralized identity management service for DOM and the HHSTP project, with the hope that it will eventually support the broader system-to-system interoperability for other Mississippi e-health initiatives.

Most importantly, the EMPI will provide the cornerstone for electronic records containing client personal and health information in the State of Mississippi.

The main purpose for an EMPI is to create unique and non-duplicated client identities across agencies and systems. The EMPI has an essential role to play, facilitating trusted data exchange while protecting the privacy of client information.

The EMPI provides a real-time way to locate, identify, match and cleanse information about a person from many sources to create a unique view.

It is proven to reduce duplicate records within and across systems to improve client administration and care. Member identification and authentication will also enhance program integrity.

Goals

• The strategic goals of the overall DOM vision for managing Medicaid identities and sharing data with providers and partners, including partner Agencies, include, but are not limited to:

*Increased Interoperability: Ensuring syntactic and semantic interoperability for exchange of health information;

*Increased Business and

Technology Alignment:
Ensuring alignment with various federal and State business/technical requirements and guidance for information technology systems.

*Shared resources: Eliminating redundant efforts. The implementation of modular components allows for a transition to an ecosystem that is in alignment with federal and state initiatives.


EMPI Project Manager Responsibilities:

• Provide overall project management for the implementation and integration of the EMPI. Provide project management on behalf of DOM, managing the design and deployment of the EMPI into the DOM and HHSTP environment, and allowing DOM to establish connectivity with both DOM internal systems and DHS.
• Perform Project Management duties including coordination with multiple contractors and stakeholders to successfully support the configuration, implementation, and integration of the HHSTP, and DOM EMPI.
• Provide detailed testing on systems and data that the EMPI will impact, including the EMPI, CDIP and HHSTP program data.
• Develop detailed EMPI and beneficiary identity management test cases.
• Report on testing and evaluate vendor testing, test cases, and results providing feedback to Project Managers for projects utilizing the EMPI (written and verbal
• Participate and provide input for data governance and data quality for the EMPI.
• Work with vendors to utilize the Kanban methodology for communication and project management.
• Manage the process for EMPI operations, patches, fixes, and upgrades.
• Manage EMPI project documentation and oversee timely delivery of documentation.
• Manage the overall DOM EMPI Project Plan in MS Project, presenting the project Plan (over the telephone and/or in person) revisions/updates to DOM and other stakeholders on a regular basis.
• Clearly communicate to DOM leadership, both verbally and in writing, the status of the project including project successes and project risks via weekly status reports and on calls.
• Provide notes and minutes of regularly scheduled project calls, meetings, and documentation of any other appropriate or related activities.
• Oversee the project data repository, ensuring the most up to date documentation and files are in the system.
• Work with the DOM Interoperability Team, IV&V contractor, HHSTP System Integrator as well as DOM and DOM Oversight team members and staff to ensure a complete, functional procurement and successful deployment of the HHSTP, and DOM EMPI.
• Provide leadership and management of stakeholders, including contractor staff, as assigned for the project.
• Work with HHSTP and DOM stakeholders to refine the project, project plan, deployment, resources, schedule, and other tasks as needed.
• Perform other duties as assigned.
• Must be onsite at DOM every other week (M-F) over the contract period.
• Maximum number of contract hours per year: 1840.
• Work will be performed during regular DOM work hours 7-6 CST; and
• Must provide a fully loaded rate (includes travel and per diem)

Must Have:
Experience performing a Project Management role on Information Technology Projects

Experience performing Project Manager lead role in Master Data Management or Master Person Index Projects

Required Skills/General Management

Expertise utilizing Microsoft Project to manage a project schedule, resources, and critical path

Communication expertise around project management tasks including reporting project status, project milestones, project achievements, and project risks verbally and in writing to senior leadership

Experience facilitating a variety of different types of project meetings with different stakeholders

Preferred Technical Skills

Project management experience that includes the deployment and harmonization/optimization of an Enterprise Master Patient Index (eMPI) across multiple data sources

Project management experience with projects with a similar size and scope to the DOM and HHSTP EMPI as outlined in RFP No

Project management experience with Health Information Exchange (HIE) deployments, interfaces, and HIE interoperability projects utilizing established industry best practices and standards

Project management experience with State Medicaid Agencies, including requirements gathering and documentation, validation of deliverables, and RFP evaluation

Project management experience with CMS and CMS processes, rules, and regulations.

Understanding of Medicaid Management Information System (MMIS) and the Electronic Data Interchange (EDI) claims process as a foundation for data aggregation and loading into disparate systems

Verifiable experience utilizing privacy and security technologies and methodologies, such as data encryption, HIPAA, patient consent / patient consent management, or patient identification

Preferred Business Skills

Ability to effectively communicate in English verbally and in writing

Ability to interact and translate between technical staff and business users regarding business and information technology needs

Strong listening and problem resolution skills

Demonstrate strong analytical skills and critical thinking skills

Ability to be flexible, multi-task and work within deadlines

Ability to work as a part of a team or independently.