MS Interoperability and Patient Access
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Job Location:
Pierre, SD - USA
Monthly Salary:
Not Disclosed
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Title: MS Interoperability and Patient Access
Location: Pierre SD (25% Onsite)
Duration: Longterm
Job Description:
The selected vendor/individual will implement and support a solution that meets the CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and the 2024 CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The primary goal is to enable health information sharing for Medicaid members with third-party applications via secure APIs.
The selected vendor/individual will implement and support a solution that meets the CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and the 2024 CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The primary goal is to enable health information sharing for Medicaid members with third-party applications via secure APIs.
Responsibilities:
API Implementation: Implement and maintain Patient Access Provider Access and Payer-to-Payer APIs compliant with FHIR version 4.0.1.
Data Maintenance: Ensure drug formularies are updated monthly and that claims/clinical data are available within one business day of receipt.
Third-Party Onboarding: Manage the registration attestation and security risk assessment process for third-party SMART on FHIR applications.
System Operations: Maintain 99.9% system availability and provide ongoing technical support and error reporting.
Security & Consent: Integrate member consent management and support identity verification via OAuth 2 and OpenID Connect.
Training: Provide initial and ongoing training for DSS staff including self-service materials like webinars and slides.
Project Management: Develop a project plan maintain a Requirement Traceability Matrix (RTM) and manage risks and issue logs.
Required Skills and Qualifications:
Technical Proficiency: Experience with FHIR version 4.0.1 or greater protocol and Cloud-hosted FHIR API servers.
Expertise in SMART on FHIR authorization frameworks.
Knowledge of publicly available implementation guides (e.g. CARIN IG US Core IG Da Vinci IG).
Ability to implement OAuth 2 and OpenID Connect for identity management.
Regulatory Knowledge: Deep understanding of CMS Final Rules CMS-9115-F and CMS-0057-F.
Operational Requirements: Ability to perform 25% of work on-site in Pierre South Dakota.
Capacity to provide a sandbox environment for third-party developer testing.
Submission Requirements: Candidates must provide resumes and references for up to three previous customers implementing similar interoperability solutions.
API Implementation: Implement and maintain Patient Access Provider Access and Payer-to-Payer APIs compliant with FHIR version 4.0.1.
Data Maintenance: Ensure drug formularies are updated monthly and that claims/clinical data are available within one business day of receipt.
Third-Party Onboarding: Manage the registration attestation and security risk assessment process for third-party SMART on FHIR applications.
System Operations: Maintain 99.9% system availability and provide ongoing technical support and error reporting.
Security & Consent: Integrate member consent management and support identity verification via OAuth 2 and OpenID Connect.
Training: Provide initial and ongoing training for DSS staff including self-service materials like webinars and slides.
Project Management: Develop a project plan maintain a Requirement Traceability Matrix (RTM) and manage risks and issue logs.
Required Skills and Qualifications:
Technical Proficiency: Experience with FHIR version 4.0.1 or greater protocol and Cloud-hosted FHIR API servers.
Expertise in SMART on FHIR authorization frameworks.
Knowledge of publicly available implementation guides (e.g. CARIN IG US Core IG Da Vinci IG).
Ability to implement OAuth 2 and OpenID Connect for identity management.
Regulatory Knowledge: Deep understanding of CMS Final Rules CMS-9115-F and CMS-0057-F.
Operational Requirements: Ability to perform 25% of work on-site in Pierre South Dakota.
Capacity to provide a sandbox environment for third-party developer testing.
Submission Requirements: Candidates must provide resumes and references for up to three previous customers implementing similar interoperability solutions.
