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. |