APD Subject Matter Expert (SME)

Description

Senior level analyst experienced in preparing federal Advance Planning Documents (APDs) on behalf of state health and human services agencies to the Centers for Medicare & Medicaid Services (CMS), Agency for Children & Families (ACF), and Food and Nutrition Service (FNS) for enhanced system funding. Must be knowledgeable in all the constituent APD components including system feasibility studies, alternatives analysis, cost benefit analysis, cost allocation plan, and other activities required by the CFR and state regulations.

Must be capable of working the state and federal regional and central office personnel to facilitate the submission and approval of APDs on a timely basis.

Minimum Training

Experience with program-specific requirements (e.g., Medicaid, S-CHIP, child welfare, TANF, Food Stamps, WIC, etc.) for systems planning and funding.

Certifications

None

Education/Experience

Minimum Bachelor’s degree with MBA or equivalent experience preferred

Budget Analyst

Description

FOX provides business analysis and health care Information Technology (IT) budgeting support to its clients. A Budget Analyst participates in analysis and recommendations to develop IT budgets to support state and federal budgeting requirements. IT budgets for the publicly funded programs such as Medicaid and Chile Welfare are multiyear budgets and, at times, require cost allocation across multiple programs in the state. Since many of the programs involve some combination of state and federal funding, or grants moneys, knowledge and expertise in program operations as well as cost accounting are key considerations.

 Essential Job Functions:

• Understands key business processes of the client’s operations and the contemplated changes in healthcare technology.

• Assists in the analysis of financial data and extracts and defines relevant information; interprets data for the purpose of determining past financial performance and develop budgets for submission to regulatory entities.

• In a cost allocation setting, reviews the multiple programs sharing IT infrastructure and IT platforms and develop cost allocation methodologies across such programs.

• Prepares presentations for clients and their representatives to support legislative or executive approvals of budgets and expenditures.

• Assists in the development of all types of budgets, including general, discretionary accounts, endowments, private, and federal funds.

• Using templates, analyzes budget patterns, projects expenditures, and prepares approved budget.

• Using templates, collects and compiles budget data, completes work papers and status reports.

• Assists in the development and maintenance of budget monitoring systems.

• Assists in the development of business proposals and/or grant applications.

• Uses appropriate cost rates, such as indirect and benefit rates for proposed budget.

• Reviews budget justification to ensure it relates to budgeted dollars.

• Ensures compliance with all relevant agency regulations and restrictions.

Minimum Training

Must be healthcare subject matter experts with work experience in a variety of important positions in the government environment and familiar with the state or federal regulations and policies.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

Eligibility System Specialist

Description

Senior consultant familiar with eligibility determination and benefits management of various federal and state human service entitlement programs. Must be able to develop functional, system and other requirements for eligibility systems and support their design, development, implementation or Independent Verification & Validation (IV&V)

Essential duties and responsibilities include the following. Other duties may be assigned.

• Identifies and documents deficiencies and dysfunctions in existing Eligibility systems.

• Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems.

• Acts as project manager on projects as assigned.

• Collects, documents, and analyzes information concerning clients’ current Eligibility systems.

• Defines, tests, and implements solutions to business and systems problems.

Minimum Training

Experience with Programs and systems with financial and other factors of eligibility determination such as Medicaid, S-CHIP, child welfare, TANF, Food Stamps, WIC, etc).

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Must have familiarity with project management tools and methodologies. Must have excellent communication, problem solving, and customer service skills.

Certifications

None

Education/Experience

Minimum bachelors degree with MBA or equivalent experience preferred

Financial Analyst

Description

FOX provides business analysis and cost benefit analysis support to its clients. A financial analyst participates in analysis and recommendations to improve the operational and financial effectiveness of client’s operations. In this capacity, the analyst analyzes the client’s business processes, extracts financial data from various accounting and information systems. Performs financial and cost accounting analysis of data, and develops cost and benefits data over 10-15 years in the future.

Essential Job Functions:

• Understands key business processes of the client’s operations and the contemplated changes in healthcare technology.
• Assists in the analysis of financial data and extracts and defines relevant information; interprets data for the purpose of determining past financial performance and the effect of new changes on client’s operations.

• Reviews costs and performs cost benefit analysis related to projects and/or programs.

• Performs statistical, cost, and financial analysis of historical data and projects future expenses resulting from investment in new technology or information systems.
• Prepares presentations for clients and their representatives to support legislative or executive approvals of budgets and expenditures.

Minimum Training

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

Health Plan Subject Matter Expert (SME)

Description

The Health Plan SME must possess knowledge of Medicare operations; Encounter Data Processing and Collection; Providing complex management and information consulting services to clients; Establishing capitation parameters for Medicare and Medicaid plans. Must also be knowledgeable in Medicare information technology systems, and federal and state Medicare reporting requirements. Responsibilities may include the following duties.

• Collects, documents, and analyzes information concerning clients’ current health plan and related systems.
• Identifies and documents deficiencies and dysfunctional areas in existing health plans and related systems.
• Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems.

• Defines, tests, and implements solutions to business and systems problems.

• Acts as project manager on projects as assigned.

Minimum Training

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Must have familiarity with project management tools and methodologies. Must have excellent communication, problem solving, and customer service skills.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

IV&V Specialist

Description

The IV&V Specialist must possess knowledge of healthcare systems and operations; developing test plans; developing communication plans; conducting system tests; reviewing application and system deliverables; coordination of deliverable reviews and finalizing review results; reviewing systems; acceptance, conversions; parallel testing; and test results. Responsibilities may include the following duties.

• Collects, documents, and analyzes information concerning clients’ current systems.

• Identifies and documents deficiencies and dysfunctional areas in existing systems.

• Defines, tests, and implements solutions to business and systems problems.

• Acts as project manager on projects as assigned.

Minimum Training

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Must have familiarity with project management tools and methodologies. Must have excellent communication, problem solving, and customer service skills.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

Medicaid Waivers Specialist

Description

• Senior consultant with knowledge and experience developing, submitting and obtaining approval for Medicaid Waivers under various waiver types such as 1115, 1115 Katrina, 1915(b), and 1915(c).

• Provides complex management and information technology consulting services to clients.

• Acts as project manager on projects as assigned.

Minimum Training

Experience with Medicaid Waiver Programs such as Long Term Care, DD, Mental Health, etc. operated in various states.

Certifications

None

Education/Experience

Minimum Bachelor’s degree with MPH, MBA or equivalent experience preferred with focus on healthcare.

MITA Specialist

Description

This Medicaid Information Technology Architecture (MITA) Specialist is a high level position that directs, establishes, maintains, and plans the overall policies and goals for business plans and operational oversight related to healthcare strategic initiatives including MITA and Health Information Exchanges (HIE).

Essential duties and responsibilities include the following. Other duties may be assigned.

• Leads Consulting Activities for MITA and HIE.

• Provides Subject Matter Expertise to related projects and business activities.

• Develops and maintains project methodology and training materials for staff development use. Includes a focus on the “train the trainer” approach to migrate new training initiatives to designated trainer(s).
• Participates in industry and standards groups to promote the strategic healthcare vision and gather information.

Minimum Training

Must have working knowledge of word processing, spreadsheet, Visio, MS Project, PowerPoint, e-mail, and Internet software.

Certifications

N/A

Education/Experience

Master’s degree (M.A.) or equivalent; or four to ten years of related experience and/or training; or equivalent combination of education and experience.

MITA Subject Matter Expert (SME)

Description

Provides complex management and information technology consulting services related to the Medicaid Information Technical Architecture (MITA) to clients by performing the following duties.

Essential duties and responsibilities include the following. Other duties may be assigned.

• Identifies and documents deficiencies and dysfunctional areas in existing systems impacted by MITA.

• Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems.

• Acts as project manager on projects as assigned.

• Collects, documents, and analyzes information concerning clients’ current clinical, financial or business processes and information systems.

• Defines, tests, and implements solutions to business and systems problems.

Minimum Training

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

Must have familiarity with project management tools and methodologies. Must have excellent communication, problem-solving, and customer service skills.

MMIS Subject Matter Expert (SME)

Description

Provides complex management and information technology consulting services related to the Medicaid Management Information System (MMIS) to clients by applying existing knowledge and expertise to performing the following duties.

Essential duties and responsibilities include the following. Other duties may be assigned.

• Identifies and documents deficiencies and dysfunctional areas in existing systems impacted by or critical to the MMIS.

• Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems. Acts as project manager on projects as assigned.

• Collects, documents, and analyzes information concerning clients’ current clinical, financial or business processes and information systems.

• Defines, tests, and implements solutions to business and systems problems.

Minimum Training

Must be proficient in word processing, spreadsheet, e-mail, database, contact management, internet, and project management software, as well as Visio.

Certifications

N/A

Education/Experience

Master's degree (M.A.) or equivalent; or four to ten years related experience and/or training; or equivalent combination of education and experience.

Must have familiarity with project management tools and methodologies. Must have excellent communication, problem-solving, and customer service skills.

Program Policy Analyst

Description

Senior Consultant capable of performing health and human service program development, assessment and implementation.

Provides complex management and information technology consulting services to clients by performing the following duties.

Essential duties and responsibilities include the following. Other duties may be assigned.

• Identifies and documents deficiencies and dysfunctions in existing programs.

• Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems.

• Acts as project manager on projects as assigned

• Collects, documents, and analyzes information concerning clients’ current programs.

• Defines, tests, and implements solutions to business and systems problems.

Minimum Training

• Experience with Medicaid Waiver Programs such as Long Term Care, DD, Mental Health, etc operated in various states.

• Must be able to understand and interpret enabling laws and regulations, define recommended programmatic options, and develop policies and procedures to support those programmatic initiatives.

Certifications

N/A

Education/Experience

Masters degree, MPA, MPH or MSW preferred, or equivalent experience

Senior Technical Analyst

Description

A Senior Technical Analyst works closely with the Client’s identified systems expert to identify existing documentation that will be useful in assessing current environments.

• Leverages identified information assessment processes.

• Supplements assessment processes with stakeholder sessions including technical experts identified by the Client’s technical lead.

• Gathers information from the existing system to determine the current system/technical maturity levels.

• Performs in key phases of projects to confirm technical baselines for use in creating the strategic plans.

• Assists in designs, programs, tests, and implements applications in a timely and efficient manner in accordance with Client procedures and standards.

• Finalize project plans, work assignments, and target dates for assigned projects.

• Analyzes requested changes and performs maintenance to existing applications.

• Assists in defining business requirements and/or problems and initiates maintenance of existing programs or designs of a new application

• Works as part of a project team to determine project requirements, goals, implementation, and schedules.

• Continues to develop technical expertise and keeps current with trends and innovations in the industry.

Minimum Training

Database Development, Database Design, HTML,ASP Java, Web Page Creation, Program Management, Project Mgmt, Quality Control training, VB, C++, MS SQL, PHP, Java programming, Systems Analysis Using CASE, Rapid Application Design Using CASE, Client/Server Application Development, Internet Application Development, SQL (Structured Query Language),
Data Modeling and Analysis, Application Development Using Visual Basic.net, Data Structures and Algorithms, Object-Oriented Programming, Network security vulnerability analysis (including wireless)

Certifications

Programming and development, security training, project management institute, MCSA, MCSE, MCDBA, MCSD

Education/Experience

AA, BS Computer and Information Sciences, or equivalent

System Architect

Description

Responsible for developing an enterprise architecture using service-oriented architecture (SOA) for the specified  program. Experience in developing business process models, business services, and solutions sets to implement the services. Experience in developing new program architecture frameworks, capability maturity models, and transition plans, and methodologies to allow client to perform self-assessments.

Minimum Training

Experience in real-time systems, Internet applications, command and control systems, data processing systems, database systems, and embedded systems. Must be familiar with system engineering tools, engineering languages, development languages, databases, and middleware products.

Demonstrated understanding and experience in client’s new framework and its design, protocols, client server applications, relational database design, data messaging, and content standards (X12, HL7, LOINC, SNOMED, ICD-10, etc.), decision support systems, data encryption, Internet protocols, and web-based interface and query design. Understanding and experience in design and development of enterprise architecture principles, practices and standards as they relate to the Federal enterprise architecture process preferred. Knowledge of business and technical requirements of large scale data processing systems changes.

Certifications

N/A

Education/Experience

Bachelors or Masters (preferred) degree in Computer Science/Information and Telecommunications System Management or equivalent combination of education and experience

Technical Analyst

Description

• A Technical Analyst works closely with the Client’s identified systems analysts in assessing current environments.

• Identifies information assessment processes.

• Supports assessment processes identified by the Client’s technical lead.

• Responsibilities also include leveraging capability statements in the planned framework against information gathered from the existing system to determine the current system/technical maturity levels.

• Performs in key phases of projects to establish technical baselines for use in creating the strategic plans.

• Designs, programs, tests, and implements applications in a timely and efficient manner in accordance with Client procedures and standards.

• Creates detailed project plans, work assignments, and target dates for assigned projects.

• Analyzes requested changes and performs maintenance to existing applications.

• Acts as a liaison to define business requirements and/or problems and initiates maintenance of existing programs or designs of a new application

• Works as part of a project team to determine project requirements, goals, implementation, and schedules.

• Provides detailed project planning on larger projects and may act as project manager on smaller projects/development efforts.

• Continues to develop technical expertise and keeps current with trends and innovations in the industry.

Minimum Training

Database Development, Database Design, HTML, ASP Java, Web Page Creation, Program Management, Project Mgmt, Quality Control training, VB, C++, MS SQL, PHP, Java programming, Systems Analysis Using CASE, Rapid Application Design Using CASE, Client/Server Application Development, Internet Application Development, SQL (Structured Query Language),
Data Modeling and Analysis, Application Development Using Visual Basic.net, Data Structures and Algorithms, Object-Oriented Programming, network security vulnerability analysis (including wireless)

Certifications

N/A

Education/Experience

AA, BS Computer and Information Sciences, or equivalent