MES Certification IT Specialist

MES Certification IT Specialist

Remote Job |   2024-03-14 10:04:11

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Job Code : NC061

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Position: MES Certification IT Specialist 

Location: Raleigh North, Carolina (Remote)

Duration: Long Term
Client: State of NC

Job ID: 729290

Job Description:

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 non-technical 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 Self-Assessment (SS-A) and performing mapping of the State's 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 (As-Is Assessment.) This position will also assist in the preparation of the State's MITA 3.0 SS-A Report. Additionally the resource may assist in determining the State's future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the State's Replacement MMIS processes to the "To-Be" 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 state-specific 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 state-specific 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 State-defined 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 (As-Is Assessment.) The resource will provide technical input to and assist in the preparation of the State's MITA 3.0 SS-A Report.

o Assist in determining the State's future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the State's Replacement MMIS processes to the "To-Be" MITA 3.0 maturity levels.

o Conduct gap analyses of the As-Is operations and To-Be 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.

o Perform crosswalks to evaluate the State Business Process Model's (BPM) alignment with or deviation from the CMS-defined 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.

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

Required

5

Years

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

Required

5

Years

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

Required

5

Years

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

Required

5

Years

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

Required

5

Years

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

Required

5

Years

Experience working in Medicaid, Health IT, Health Insurance environment

Highly desired

5

Years

Excellent communication skills, both verbal and written

Required

5

Years

5+ years Business Analyst or Product Management experience

Highly desired

5

Years

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

Highly desired

5

Years

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

Highly desired

5

Years

Medicaid, MMIS, claims process or related experience

Required

5

Years

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