MES Certification IT Specialist

NC DHHS is seeking certification specialist to support business process analysis and requirements gathering for various Information Technology systems within the Medicaid Enterprise. Remote position from anywhere in the USA.

NC DHHS is seeking IT Specialist to join the systems certification team and support the business process analysis and requirements gathering to ensure effective implementation of Technology systems supporting the Medicaid Enterprise Systems. The support will involve the development and documentation regarding various Departmental Information Technology systems for the primary business functions for Medicaid. This documentation will support a wide range of objectives that include user guides CMS certification enterprise architecture and procurement. While some of this documentation will be highly technical most of the documentation must be written for consumption by both technical and nontechnical audiences.

The primary responsibility of this role is to work with the Business Leads Project Teams functional / matrix managers vendors and other stakeholders to develop state specific outcome statements and to ensure that project requirements are aligned to CMS expectations. State specific outcome statements and KPIs must be delivered on schedule and written to ensure successful MMIS / CMS Certification consistent with Program Management guidelines / processes and CMS expectations.

This role will report directly to the Systems Certification Manager and will play a key role in supporting multiple project teams to maintain the relationship in planning and executing CMS certification activities in implementing complex systems in support of NC Department of Health and Human Services programs.

The resource will support the MITA 3.0 State SelfAssessment (SSA) and performing mapping of the States Replacement MES requirements and business processes (which were developed as part of System Design) to the Centers for Medicaid and Medicare Services (CMS) MITA Business Processes and Business Capabilities Matrices to determine the MITA 3.0 maturity level of the Replacement MMIS (AsIs Assessment.) This position will also assist in the preparation of the States MITA 3.0 SSA Report. Additionally the resource may assist in determining the States future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the States Replacement MMIS processes to the ToBe MITA 3.0 maturity levels. A major component of this role will be the support of the CMS Information Technology Systems certification exercise which is heavily reliant on MITA compliance for the technical architecture for deployed IT systems.

Essential Responsibilities

Responsible for the overall development of the statespecific outcome statements and KPIs in coordination with the project teams

Responsible for pulling recommending and managing evidence from the implemented solution to meet CMS Certification requirements

Reviews State Goals and Objectives to identify draft and maintain statespecific outcomes for each project

Assists with composing certification evidence packages for CMS Reviews

Reviews system demonstrations to ensure certification criteria is presented to achieve CMS Certification

Assists the Systems Certification Manager with addressing all exceptions and action items pertaining to CMS Certification

Provides education to project team members and stakeholders on CMS certification process including outcome statements and KPI development

Maintains awareness of CMS certification program and policy updates organization communication as applicable

Contributes to schedule activities to project teams for CMS efforts

Participates in CMS certification activities for assigned projects including but not limited to all milestone reviews and meetings

The resource will ensure the utilization of industry best practices for compliance with CMS and Statedefined performance standards

Participates in RFP development for CMS scope of work

Additionally this resource may interface with Division Leadership and other DHHS Subject Matter Experts (SME) as required to complete the work

Additional key functions of this role will be the collection of technical specifications that must be consolidated into cohesive documentation that is both accurate and easy to understand.

Identify and document business processes and data flows

Identify and document detailed business requirements related to the business processes

Document gap analysis and assist with the development of project artifacts including test plans

Support the development of the procurement documents including the RFP

Coordinate necessary meetings to determine business requirements

Additional tasks are documenting the requirements traceability and participating in user acceptance testing.

Expected Skills : Able to work without assistance; can provide leadership to others; able to manage highly complex work efforts; may have advanced education; may have extensive industry experience.

Description :

Collect documentation requirements from business and technical staff.

Collaborate with technical staff to consolidate and interpret technical information.

Edit written documentation from business and technology staff to create unified and consistent system certification package aligning with federal standards.

Develop an understanding of the business functions and systems in support of articulating the objectives within the associated documentation and alignment with federal guidelines.

Coordinate and meet with various teams vendors and stakeholders to support the gathering analysis and finalization of information that will be used for associated business process alignment and system certification documentation.

Preferred Technical and Professional Expertise

3 years MMIS / CMS certification experience

5 years Business Analyst or Product Management experience

State government / public sector experience with health and human services programs (such as Medicaid MMIS claims processing eligibility HHS analytics etc.)

5 years of requirements gathering experience including experience eliciting requirements from business owners

5 years experience managing multiple priorities / projects including project scope schedules quality change management and project financials

5 years experience implementing information systems in client facing role

3 years healthcare related knowledge ideally in analytics reporting or related

Demonstrated experience using project tracking tools (Microsoft Project (e.g. Jira MITAPulse)

Preferred Technical and Professional Expertise

3 years of CMS Medicaid Enterprise Certification Life Cycle process experience

3 years of Medicaid MMIS claims process or related experience

Experience with implementation / SDLC methodologies e.g. Agile waterfall hybrid and / or iterative

Knowledge of MITA 3.0

CMMI (Capability Maturity Model Integration) experience

Capabilities Matrices to determine the MITA 3.0 maturity level of the Replacement MMIS (AsIs Assessment.) The resource will provide technical input to and assist in the preparation of the States MITA 3.0 SSA Report.

oAssist in determining the States future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the States Replacement MMIS processes to the ToBe MITA 3.0 maturity levels.

oConduct gap analyses of the AsIs operations and ToBe environments to identify appropriate actions needed to reach target maturity levels and may develop the technical documentation for compliance with the CMS Seven Standards and Conditions.

oPerform crosswalks to evaluate the State Business Process Models (BPM) alignment with or deviation from the CMSdefined MITA BPM.

This is a remote position and candidates are welcome anywhere in the US. Equipment will be provided and VPN access and collaboration tools are available.

Required / Desired Skills

Skill

Required / Desired

Amount

of Experience

MMIS / CMS certification experience or CMS Medicaid Enterprise Certification Life Cycle process experience

Required

Years

State government / public sector experience with health and human services programs (Medicaid MMIS claims processing eligibility HHS analytics)

Required

Years

Experience documenting business process flows and related JAD and RFP development / review actions

Required

Years

Experience executing against multiple priorities / projects including with knowledge of scope schedule quality and change management

Required

Years

Experience documenting status reports standard operating procedures (SOP) policies and procedures CMS documentation related to MMIS Certification

Required

Years

Experience with implementation / SDLC methodologies e.g. Agile waterfall hybrid and / or iterative

Required

Years

Experience working in Medicaid Health IT Health Insurance environment

Highly desired

Years

Excellent communication skills both verbal and written

Required

Years

5 years Business Analyst or Product Management experience

Highly desired

Years

5 years of requirements gathering experience including experience eliciting requirements from business owners

Highly desired

Years

Demonstrated experience using project tracking tools (Microsoft Project (e.g. Jira MITAPulse)

Highly desired

Years

Medicaid MMIS claims process or related experience

Required

Years

Knowledge of MITA 3.0 and CMMI (Capability Maturity Model Integration) experience

Required

Years

Questions

Question

Question1

Absences greater than two weeks MUST be approved by CAI management in advance and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you accept this requirement

Question2

Please list candidates email address HERE that will be used when submitting ERTR.

Question3

Please indicate how soon this candidate is available to start work. Vendors are encouraged to submit candidates that are available for the duration of the assignment.

Question4

Vendor must disclose to the agency if the candidate will be subcontracted at the time of submission. Do you accept this requirement

Question5

Vendor must notify the agency if any portion of the requirements listed in this task order is to be outsourced to other countries. Do you accept this requirement

Question6

Candidates submitted above the bill rate of XX81.99 will NOT be considered. Do you accept this requirement

Question7

Upon selection candidate must be able to provide three (3) references from prior engagements before a final decision is made. Do you accept this requirement

Question8

Please confirm you have thoroughly validated and attest to the accuracy of the credentials listed throughout this candidate s VectorVMS profile and resume pursuant to Section 5.2.5 of ITS009440. Do you confirm