Senior HL7 Interoperability Engineer

3. Position Description and Job Skill Set

Description of the job functions the contractor will be expected to perform. 

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, MarkLogic 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).

The contractor shall provide technical leadership and operational services across the following functional domains. The scope encompasses both ongoing operational responsibilities and active interoperability initiatives.

1) Healthcare Interface Management & Operations

a)            Manage, monitor, and maintain HL7 and FHIR-based healthcare interfaces across DOM's integration environment, ensuring availability, accuracy, and reliable data exchange.

b)            Oversee the Infor Cloverleaf integration engine, including interface configuration, message routing, transformation, error handling, and performance tuning.

c)             Interpret, refine, and optimize existing interfaces to improve data accuracy, reliability, processing throughput, and operational efficiency.

d)            Triage and resolve interface failures, message errors, and data exchange issues in a timely manner consistent with incident severity levels.

e)            Coordinate with external trading partners, including MCOs, providers, payers, and state and federal agencies, on interface connectivity, onboarding, and issue resolution.

2) Interoperability & Regulatory Compliance

a)            Support DOM's compliance with CMS-9115-F (Interoperability and Patient Access) and CMS-0057-F (Interoperability and Prior Authorization) final rules, including all applicable FHIR API implementation requirements.

b)            Support FHIR API implementations including Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs.

c)             Ensure interfaces and data exchange processes align with HL7 FHIR standards, US Core Implementation Guides, Da Vinci Implementation Guides, and USCDI data element requirements.

d)            Coordinate with AWS, MarkLogic, Cloverleaf, and other vendor and platform teams on interoperability solution delivery and technical issues.

e)            Keep current with CMS interoperability regulations and advise DOM IT leadership on compliance implications, required actions, and implementation timelines.

3) Interface Documentation & Process Improvement

a)            Develop and maintain comprehensive documentation for all healthcare interfaces, including interface specifications, data flow diagrams, mapping documents, message type inventories, and standard operating procedures (SOPs).

b)            Conduct a current-state assessment and evaluation of all existing interfaces to determine whether they are up to standard, optimized, and properly documented; identify and prioritize gaps.

c)             Map and document all HIPAA-covered interfaces, including data sources, destinations, message types, exchange frequency, and data elements exchanged.

d)            Identify and implement interface process improvement, standardization, and automation opportunities to improve reliability and reduce manual operational burden.

e)            Develop and maintain interface runbooks, troubleshooting guides, and a knowledge base to support operational continuity and staff cross-training.

4) Document Management Systems

a)            Implement, configure, and maintain document management systems supporting DOM's interoperability operations, IT governance, and compliance documentation requirements should DOM decide to implement a document management system.

b)            Establish and enforce document governance processes including version control, access management, naming conventions, retention policies, and compliance documentation standards.

c)             Organize and manage project artifacts, SOPs, interface documentation, and compliance records within document management platforms.

d)            Ensure document management practices align with HIPAA, CMS, and State of Mississippi records management requirements.

5) Cloverleaf Configuration Migration

a)            Plan and support the potential migration of the Infor Cloverleaf integration engine configuration to a new infrastructure environment, anticipated within the next six (6) months.

b)            Develop migration plans, interface validation test strategies, and rollback procedures for all Cloverleaf configuration changes and migration activities.

c)             Coordinate with infrastructure, network, and vendor teams to ensure the migration is executed with minimal disruption to interface operations and trading partner connectivity.

d)            Validate all interfaces post-migration to confirm data integrity, message accuracy, and full operational continuity for all trading partners and data exchange flows.

10)          Prepare and deliver status reports to IT leadership summarizing interface operations, open issues, project progress, and team activities.

11)          Participate in interoperability project meetings, vendor coordination calls, and CMS compliance reviews as required. 12) Develop and maintain interface standards, naming conventions, and best practices documentation to support operational consistency across DOM's integration environment.

Security and Compliance Requirements

1)            The contractor shall pass a background investigation as required by the State of Mississippi and DOM prior to commencing work.

2)            The contractor shall comply with all HIPAA Privacy and Security Rule requirements, including safeguarding of Protected Health Information (PHI) and electronic PHI (ePHI) encountered in the course of interface operations and data exchange activities.

3)            The contractor shall comply with CMS Acceptable Risk Controls for Automated Medicaid Program Eligibility (ARCAMPE) and all applicable federal security requirements.

4)            The contractor shall adhere to Mississippi ITS security policies, standards, and procedures applicable to Medicaid systems and data.

5)            The contractor shall complete all required security awareness training within thirty (30) days of onboarding and annually thereafter.

6)            The contractor shall execute a Non-Disclosure Agreement (NDA) and any additional confidentiality agreements required by DOM.

7)            The contractor shall not remove, copy, or transmit DOM data, documents, or systems information without prior written authorization from DOM.

8)            Upon termination or completion of the engagement, the contractor shall return all DOM property and all credentials and system access shall be revoked the last day of employment.

12)          Prepare and deliver status reports to IT leadership summarizing interface operations, open issues, project progress, and team activities.

13)          Participate in interoperability project meetings, vendor coordination calls, and CMS compliance reviews as required. 12) Develop and maintain interface standards, naming conventions, and best practices documentation to support operational consistency across DOM's integration environment.

Security and Compliance Requirements

9)            The contractor shall pass a background investigation as required by the State of Mississippi and DOM prior to commencing work.

10)          The contractor shall comply with all HIPAA Privacy and Security Rule requirements, including safeguarding of Protected Health Information (PHI) and electronic PHI (ePHI) encountered in the course of interface operations and data exchange activities.

11)          The contractor shall comply with CMS Acceptable Risk Controls for Automated Medicaid Program Eligibility (ARCAMPE) and all applicable federal security requirements.

12)          The contractor shall adhere to Mississippi ITS security policies, standards, and procedures applicable to Medicaid systems and data.

13)          The contractor shall complete all required security awareness training within thirty (30) days of onboarding and annually thereafter.

14)          The contractor shall execute a Non-Disclosure Agreement (NDA) and any additional confidentiality agreements required by DOM.

15)          The contractor shall not remove, copy, or transmit DOM data, documents, or systems information without prior written authorization from DOM.

16)          Upon termination or completion of the engagement, the contractor shall return all DOM property and all credentials and system access shall be revoked the last day of employment.

Required Skills/Experience

Provide the minimum required skills and/or experience the contractor must possess to qualify for this position.  These requirements will be transferred to the Score Sheet and candidates without these requirements reflected on their resume will NOT be presented to the manager for consideration.  

The contractor personnel assigned to this engagement shall possess, at a minimum, the following qualifications:

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 totaling 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 EHR 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.