167866: Lead Interface & Medicaid Analyst
Jackson, MS (Onsite)
24 Months
Position Description:
DOM is actively implementing federal interoperability mandates under CMS-0057-F (Interoperability and Prior Authorization Final Rule). These rules require DOM to implement and maintain Patient Access APIs, Provider Directory APIs, Provider Access APIs, Payer-to-Payer APIs, and Prior Authorization APIs based on HL7 FHIR standards. DOM's interoperability environment relies on Infor Cloverleaf as the primary integration engine, Mark Logic as the data store, and FHIR-based APIs for data exchange with multiple external partners including managed care organizations (MCOs), providers, payers, and state and federal agencies. DOM exchanges health data with multiple external sources and maintains a complex portfolio of HL7 and FHIR-based healthcare interfaces. These interfaces require ongoing management, optimization, documentation, and governance to ensure accurate, reliable, and compliant data exchange. Existing interfaces require a comprehensive current-state assessment, standardized documentation, and a structured process improvement program to ensure they meet current standards and are optimized for performance and reliability.
The purpose of this Statement of Work (SOW) is to procure staff augmentation services for one (1) Lead Interface & Interoperability Analyst to provide senior-level technical leadership for DOM's healthcare interface operations, interoperability compliance activities, interface documentation and process improvement, document management, and small team leadership. The contractor shall report directly to the DOM Chief Information Officer (CIO), Director of Solutions, and/or Chief Technology Officer (CTO).
Required Skills:
1) Ten (10) or more years of progressive healthcare information technology experience with direct, hands-on experience in HL7 and/or FHIR-based healthcare interfaces. Any combination of HL7 v2.x and HL7 FHIR experience to taling ten (10) or more years is acceptable.
2) Demonstrated experience with healthcare integration engines, preferably Infor Cloverleaf, Rhapsody, or equivalent enterprise integration platforms.
3) Strong understanding of healthcare data standards including HL7 v2.x, HL7 FHIR R4, CDA, CCDA, X12, and USCDI data element requirements.
4) Experience with healthcare interoperability in a Medicaid, managed care, hospital/health system, or HER environment.
5) Experience with EHR interfaces and clinical data exchange.
6) Demonstrated experience implementing and maintaining document management systems and establishing document governance processes.
7) Experience leading or supervising technical teams or contractors, including work assignment, quality review, and performance oversight.
8) Strong understanding of HIPAA Privacy and Security Rule requirements as they relate to healthcare data exchange and interface operations.
9) Experience with interface documentation, data flow mapping, and interface process improvement.
10) Excellent written and verbal communication skills, including the ability to create technical documentation and present findings and recommendations to IT leadership audiences.
11) Master's degree in Information Technology, Health Informatics, or a related management or technology discipline.
The following qualifications are preferred but not required:
1) Experience working in state or federal government IT environments, preferably within a Medicaid, healthcare, or human services agency.
2) Direct experience supporting CMS interoperability mandates including CMS-9115-F and CMS-0057-F, including FHIR API implementation and compliance documentation.
3) Experience with Infor Cloverleaf configuration, administration, and environment migration.
4) Experience with Mark Logic or similar NoSQL databases in a healthcare data management context.
5) Experience with FHIR API development, testing, or implementation including US Core and Da Vinci Implementation Guides.
6) Experience with SMART on FHIR and OAuth 2.0 authentication frameworks for FHIR API access management.
7) HL7 certification or equivalent industry credential in healthcare informatics or integration.
8) Experience with corporate or enterprise document management platforms.
9) Experience with cloud platforms, particularly Amazon Web Services (AWS), in a healthcare or government context.
10) Project Management Professional (PMP) or similar project management certification.
11) Experience with CMS ARC-AMPE security requirements and Medicaid system security compliance.
Regards,
Satya
Sr. Technical Recruiter
Key Business Solutions, Inc
