Complete Description:
The District of Columbia Department of Healthcare Finance (DHCF) is the agency within the District’s government that administers the Medicaid program – a program responsible for providing healthcare services for more than one-third of the District’s residents. The District’s Medicaid Management Information System (MMIS) processes the healthcare claims submitted by the Medicaid providers for services rendered to the aforementioned beneficiaries. The number of healthcare claims exceeds one million a monthly. Annual payments for the District’s Medicaid program are in excess of $1.2 billion.
The MMIS serves as the central platform that DC Medicaid uses to manage, monitor, and administer the Medicaid program. The MMIS is comprised of seven major subsystems to include Claims, Provider, Third Party Liability, Recipient, and Reference. Enrolled within the MMIS today are more than seven thousand Medicaid providers and more than 200,000 Medicaid and Alliance beneficiaries.
The existing MMIS contract was awarded in September 2007 and the system became operational in November 2009. The Centers for Medicare and Medicaid Services (CMS) requires state Medicaid agencies to perform a technology refresh on their MMIS enterprise platforms every five to ten years to ensure that the system can keep up with all of the Medicaid program changes.
To facilitate the procurement and implementation of a new MMIS, DHCF will need to begin drafting a new request for proposal (RFP). DHCF is seeking to bring in a senior project manager that will lead this development effort. In order to develop the new RFP, the senior project manager will need to meet with the key stakeholders in each of the agency’s business units to capture their requirements for the new system. Additionally, the senior project manager will work with the vendor currently responding for conducting the Medicaid Information Technology Assessment.
The senior project manager’s responsibilities will include:
• Meeting with key DHCF agency stakeholders to when developing the MMIS RFP
• Serving as the lead for DHCF when communicating with CMS
• Serving as the lead author for the new MMIS RFP
• Participating in Medicaid Information Technology Architecture (MITA) sessions and applying lessons learned to the development of the MMIS RFP
• Researching recently released MMIS RFP from other states to determine the best strategy / approach for DC Medicaid
• Serves as DHCF’s primary liaison with the District’s Office of Contracting and Procurement for matters concerning the MMIS RFP
• Develop and manage the overall MMIS re-procurement timeline
Skills:
Skill
Required / Desired
Amount
of Experience
Expertise Rating
Project management experience
Required
10
Years
3 - Expert
Medicaid Management Information System (MMIS) experience
Required
15
Years
3 - Expert
Systems development life cycle (SDLC) experience
Required
10
Years
3 - Expert
Request for Proposal (RFP) experience
Required
8
Years
3 - Expert
Experience with the Centers for Medicare and Medicaid Services
Required
5
Years
3 - Expert
Experience with Medicaid Information Technology Assessment (MITA)
Required
2
Years
3 - Expert
PMP Certified
Required
Medicaid Management Information Systems Implementation experience
Required
8
Years
3 - Expert