Key Duties:
The contractor shall perform the following duties on an ongoing basis:
· Manage daily healthcare interface operations, ensuring availability, accuracy, and performance of all data exchange processes across Cloverleaf and FHIR API environments.
· Monitor, triage, and resolve interface errors, message failures, and data exchange issues; coordinate with trading partners as needed to restore normal operations.
· Develop and maintain comprehensive interface documentation including interface specifications, data flow maps, SOPs, and operational runbooks.
· Continue current-state assessment of all existing interfaces; identify and implement optimization opportunities to improve performance, reliability, and standards compliance.
· Support CMS-9115-F and CMS-0057-F compliance activities including FHIR API testing, validation, documentation, and go-live support.
· Coordinate with external trading partners, including MCOs, providers, and payers, on interface onboarding, connectivity, and issue resolution.
· Lead and manage the interoperability contractor team; assign work, review deliverables, provide technical direction, and report team status to IT leadership.
· Implement and maintain document management systems and governance processes for interoperability and IT operations documentation if DOM procures a solution.
· Plan and execute Cloverleaf configuration migration activities, including coordination with infrastructure and vendor teams, validation testing, and post-migration verification.
· Prepare and deliver status reports to IT leadership summarizing interface operations, open issues, project progress, and team activities.
· Participate in interoperability project meetings, vendor coordination calls, and CMS compliance reviews as required.
· Develop and maintain interface standards, naming conventions, and best practices documentation to support operational consistency across DOM’s integration environment.
Security and Compliance Requirements:
· The contractor shall pass a background investigation as required by the State of Mississippi and DOM prior to commencing work.
· 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.
· The contractor shall comply with CMS Acceptable Risk Controls for Automated Medicaid Program Eligibility (ARC-AMPE) and all applicable federal security requirements.
· The contractor shall adhere to Mississippi ITS security policies, standards, and procedures applicable to Medicaid systems and data.
· The contractor shall complete all required security awareness training within thirty (30) days of onboarding and annually thereafter.
· The contractor shall execute a Non-Disclosure Agreement (NDA) and any additional confidentiality agreements required by DOM.
· The contractor shall not remove, copy, or transmit DOM data, documents, or systems information without prior written authorization from DOM.
· 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:
The contractor personnel assigned to this engagement shall possess, at a minimum, the following qualifications:
· 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.
· Demonstrated experience with healthcare integration engines, preferably Infor Cloverleaf, Rhapsody, or equivalent enterprise integration platforms.
· Strong understanding of healthcare data standards including HL7 v2.x, HL7 FHIR R4, CDA, CCDA, X12, and USCDI data element requirements.
· Experience with healthcare interoperability in a Medicaid, managed care, hospital/health system, or EHR environment.
· Experience with EHR interfaces and clinical data exchange.
· Demonstrated experience implementing and maintaining document management systems and establishing document governance processes.
· Experience leading or supervising technical teams or contractors, including work assignment, quality review, and performance oversight.
· Strong understanding of HIPAA Privacy and Security Rule requirements as they relate to healthcare data exchange and interface operations.
· Experience with interface documentation, data flow mapping, and interface process improvement.
· Excellent written and verbal communication skills, including the ability to create technical documentation and present findings and recommendations to IT leadership audiences.
· Master’s degree in Information Technology, Health Informatics, or a related management or technology discipline.
Preferred /Not Required:
The following qualifications are preferred but not required:
· Experience working in state or federal government IT environments, preferably within a Medicaid, healthcare, or human services agency.
· Direct experience supporting CMS interoperability mandates including CMS-9115-F and CMS-0057-F, including FHIR API implementation and compliance documentation.
· Experience with Infor Cloverleaf configuration, administration, and environment migration.
· Experience with MarkLogic or similar NoSQL databases in a healthcare data management context.
· Experience with FHIR API development, testing, or implementation including US Core and Da Vinci Implementation Guides.
Experience with SMART on FHIR and OAuth 2.0 authentication frameworks for FHIR API access management.
· HL7 certification or equivalent industry credential in healthcare informatics or integration.
· Experience with corporate or enterprise document management platforms.
· Experience with cloud platforms, particularly Amazon Web Services (AWS), in a healthcare or government context.
· Project Management Professional (PMP) or similar project management certification.
· Experience with CMS ARC-AMPE security requirements and Medicaid system security compliance.
