Job ID: NC-620734 (98190326)
Medicaid QA Lead with MS Project/Access, CMS Seven Standards, Adobe and Vendor Quality Management/Policy experience
Location: Raleigh, NC (NCDHHS)
Duration: 12 months
Interview: Either Webcam Interview or In Person
Skill Required / Desired Amount of Experience
Knowledge of Enterprise IT Systems, system integration principles, and associated program, project, quality and test management best practices.Required3Years
Has an understanding of CMS’ Seven Standards and Conditions and the Medicaid programHighly desired5Years
Demonstrated ability to manage multiple priorities and projects, function in a fast-paced moving constantly changing, deadline driven environmentRequired5Years
Proficient use of Microsoft Project, Word, Excel, PowerPoint, Access, and Adobe softwareRequired5Years
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levelsRequired5Years
Knowledge of planning, design and implementation of a Vendor Quality Management program including the policy, framework and proceduresRequired3Years
The IT Quality Specialist (IT-QAS) will be responsible for ensuring that the impact of new or upgraded IT systems are effectively implemented to support the delivery of desired business and technology outcomes. The role will work with the business and technology change management, process improvement, vendor management, and application support teams for the governance model to achieve required outcomes.
The ITQAS plays a pivotal role in supporting stakeholders by providing guidance and expertise in the validation of business and technology specifications required to achieve a high quality of Vendor services provided within the MES program framework. Additionally, the Specialist also has responsibility for supporting DHHS internal business units with sourcing and vendor selection, contract drafting and pricing negotiations, risk mitigation, vendor on boarding, and on-going vendor quality monitoring responsibilities. The Specialist will lead multiple projects within different internal departments. In this role, you will be working with a variety of Information Technology Vendors.
The resource will support the MITA 3.0 State Self-Assessment (SS-A) and performing mapping of the State’s Replacement MES requirements and business processes (which were developed as part of System Design) to the Centers for Medicaid and Medicare Services (CMS) MITA Business Processes and Business Capabilities Matrices to determine the MITA 3.0 maturity level of the Replacement MMIS (As-Is Assessment.) The ITQAS will also assist in the preparation of the State’s MITA 3.0 SS-A Report. Additionally the resource may assist in determining the State’s future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the State’s Replacement MMIS processes to the "To-Be" MITA 3.0 maturity levels. A major component of this role will be the support of the CMS Information Technology Systems certification exercise which is heavily reliant on MITA compliance for the technical architecture for deployed IT systems.
This resource may interface with Division Leadership and DHHS Subject Matter Experts (SME) as required to complete the work. This role is focused on managing and monitoring integration efforts and compliance. Participation in drafting procurement documentation (RFI and IFB, RFP, and RFQ) is key aspect. Interface with business stakeholders will occur daily.
QA Validation Support
oCreating, updating and maintaining quality reporting and communicate performance trends to program management.
oIdentifying trends and overseeing projects to lead continuous improvement and problem-solving efforts to improve quality
oAggregating and analyzing quality data and recommending methods for improving product and service quality, design and/or business processes.
oMonitoring, identifying, and analyzing performance metrics in order to provide constructive feedback, maintain high-service levels, and increase production system efficiency.
oCoordinating with NC Medicaid PMO and NC Medicaid O&M to ensure all program review findings are identified, tracked. Ensuring a mitigation plan is in place with defined dates for resolution.
oReviewing product history and lessons learned from design validation sources, current production quality, and warranty data to identify and drive preventive measures to ensure optimal quality of each project as it is implemented.
oActing as liaison to federal program reviewers and State and DHHS Project Monitoring Oversight teams.
oFollowing up with management on all exceptions and corrective actions pertaining to quality reviews by staff.
oResponsible for supporting the quality review of the MITA 3.0 State Self-Assessment (SS-A) and performing mapping of the State’s Replacement MES requirements and business processes (which were developed as part of System Design) to the Centers for Medicaid and Medicare Services (CMS) MITA Business Processes and Business Capabilities Matrices to determine the MITA 3.0 maturity level of the Replacement MMIS (As-Is Assessment.) The resource will provide technical input to and assist in the preparation of the State’s MITA 3.0 SS-A Report.
oAssist in determining the State’s future goals for MITA (technology framework and business processes) by leading meetings with internal stakeholders and vendors to map the State’s Replacement MMIS processes to the "To-Be" MITA 3.0 maturity levels.
oSupport of the CMS Information Technology Systems certification exercise which is heavily reliant on MITA compliance for the technical architecture for deployed IT systems.
oConduct gap analyses of the As-Is operations and To-Be environments to identify appropriate actions needed to reach target maturity levels, and may develop the technical documentation for compliance with the CMS Seven Standards and Conditions.
oPerform crosswalks to evaluate the State Business Process Model’s (BPM) alignment with or deviation from the CMS-defined MITA BPM.
oEnsure the utilization of industry best practices for compliance with CMS and State-defined performance standards.
oProvide day-to-day technical advice to the MITA team members in the completion of the "As Is" assessment and strategic advice as requested.
oPerform pre-contract support, including vendor pre-qualification (RFI and IFB, RFP, and RFQ)
oInterface with Business Owners to ensure contract negotiation objectives align with key stakeholder expectations and provide project status and analysis throughout the negotiation and contract development phases
oEvaluate vendor documents to determine acceptability based on business unit needs and Federal/State standards
oDevelop goals and metrics for measuring and managing supplier quality
oMitigate vendor risk and create third party contingency plans
oAssist in validation of IT systems, evaluation of requirements, and testing.
oAssist in the planning, design and implementation of a Vendor Quality Management program including the policy, framework and procedures
oOversees the quality review process, including risk assessment and due diligence through partnerships with Legal, business unit and security to ensure all requirements are met.
oParticipates in design, code, and test inspections throughout product life cycle to identify issues from a quality assurance viewpoint.
oThoroughly understands and complies with quality policies and procedures, and verifies deliverables meet expected quality requirements.
oParticipates as a quality assurance technical representative at other project meetings. Presents quality assurance technical status’ and issues at milestone reviews.
oConsidered subject matter expert in associated risk and quality management methodology
oReview vendor risk assessment outputs to ensure risk has been appropriately assessed
oDelivers reporting from the risk management platform and team presentations to stakeholders
oAid in design, creation and delivery of program training to internal business unit stakeholders
oEnsure departmental documents and activities are performed in compliance with applicable laws, regulatory standards and company policies and procedures
oParticipate in team’s preparation and involvement in regulatory examinations
oAssist with the creation of policies and procedures
oAnalyze data to drive recommendations
oChallenges and provides process improvement strategies on existing procedures and processes across the team and risk organization to achieve efficiencies.
oBasic understanding of SOC reports, Business Continuity Planning, Inherent Risk and Entity Level Controls
oCreates, modifies, and extracts reports and dashboards to communicate key metrics.
oCreate and Implement a quality management and risk management process
oBuild the methodology to measure and improve vendor quality
In addition to the above, the candidate may also conduct gap analyses of the As-Is operations and To-Be environments to identify appropriate actions needed to reach target maturity levels, and may develop the technical documentation for compliance with the CMS Seven Standards and Conditions. The resource will perform crosswalks to evaluate the State Business Process Model’s (BPM) alignment with or deviation from the CMS-defined MITA BPM. This resource will work under the direction of the MES Lead Project Manager and in concert with additional MITA staff in the performance of the work. The resource will ensure the utilization of industry best practices for compliance with CMS and State-defined performance standards. This resource will provide day-to-day technical advice to the MITA team members in the completion of the "As Is" assessment and strategic advice as requested. Additionally, this resource may interface with Division Leadership and other DHHS Subject Matter Experts (SME) as required to complete the work.