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Indiana - FSSA - Eligibility Modernization

Indiana -FSSA - Eligibility Sys Planning  

Indiana -FSSA - Medicaid Mgmt Info Sys  

Indiana -INDOT -   Quality Assurance  

Illinois -Dept of Insurance -   Health Benefit Exchange

Client Eligibility System Modernization

Indiana FSSA’s Client Eligibility Modernization Project is one of the largest (budget $1.4 billion) and most complex human and health services projects in the country. The enhanced business model and automated system implemented by the project provides various tools to strengthen families through services that focus on prevention, early intervention, self-sufficiency, family support and preservation. It helps FSSA efficiently administer various public assistance programs such as SNAP, Medicaid, TANF (cash assistance), child care assistance, employment and training services for low-income clients as well as Medicaid eligibility throughout the State of Indiana.

eSense staff is providing verification and validation services with the primary objectives of verification and enhancement of project management disciplines, vendor and program oversight inclusive of validation of deliverables and other project results, quality assurance and advice to the State and other project sponsors, and knowledge transfer assistance to the State Project Management Office (PMO).
Key tasks performed by eSense on the project include:
• Prepare and provide Quarterly Project Status Reports that focus on verification and validation analysis of performance of all vendors working on the project.
• Manage formal communications, operational reports and deliverable submissions from stakeholders, vendors to the State; ensure incoming correspondence is processed in a timely manner. Processing includes creation of tracking records as applicable, distribution of information or documentation to involved individuals, sorting and storage of communications in descriptive folders and documentation in the Project document repository.
• Provide support and assistance to help identify issues and risks, and, participate in PMO's issues and risk management process as directed by the State.
• Provide Change Control Management support to the State. Conduct research and analysis and report on submitted change requests. Participate in change control review. Provide support and assistance for change control monitoring and tracking. Provide support for monitoring status and implementing changes.
• Provide support in the on-going development and maintenance of the SharePoint document repository. Post documentation to associated SharePoint folders. Retrieve and respond to documentation requests from State or legal entities. Participate in SharePoint functional assessment to improve/modify structure or procedures. Conduct documentation research and data analysis.
• Assist the State management team in developing vendors' contract performance metrics that will assist the State in meeting their strategic policy objectives particularly in the areas of quality and timeliness. Review data and outcomes to determine if the metrics achieve the State's intended goals and objectives, and recommend any changes that are needed.
• Prepare Advanced Planning Documents and coordinate correspondence with Federal government agencies, Centers for Medicare and Medicaid Services (CMS) and Food and Nutrition Services (FNS), funding the project.
• Assist the State in regular and ad-hoc quality management activities.
• Provide assistance and support to the State management for FNS sponsored studies, such as the Performance Standards and Reporting for SNAP Modernization Initiatives study conducted by FNS. Activities include coordinating the study in Indiana; compiling surveys; providing performance data and reports to the agency conducting the study; organizing phone interviews and meetings with the state, county and local agencies for the study; organizing phone interviews and meetings with various project partners, vendors that assist applicants or participants or businesses that provide contracted services; organizing on-site visits in the state to help collect more in-depth information regarding modernization initiative's performance management systems.
• Monitor and report task volume data for vendors and FSSA on an ongoing basis. This data is used to identify dramatic changes in task volumes, to conduct trend analysis, to identify task volume backlog issues, and to assist DFR in resource assignment to address task volume concerns.
• Review deliverables and other work products produced by the IEMP vendors. Work with the State and the IEMP vendors throughout the entire deliverable and work product development, review, comment, and approval process. The OV&V Team will assist the State in defining and evaluating the format and content of deliverables and work products, and will assign a coordinator to each to ensure a single point of contact for all associated OV&V work.
• Conduct case reviews each month to provide the State with overall case quality data relative to data gathering and case documentation which supports the eligibility decision. A random sample is selected comprised of TANF, SNAP, LTC Medicaid, and Other Medicaid including HIP categories. As requested, the mix of cases selected may change based on the needs of the State.

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Eligibility Determination Services System Planning and Procurement

Indiana FSSA’s Planning and Procurement phase of a large project to procure a System Implementation (SI) Contractor to design, develop, implement and operate new Indiana Eligibility Determination Services System (IEDSS) and Health Insurance Exchange. The new system will meet FSSA’s strategic goals of integrating and coordinating policy development and service delivery within FSSA Divisions and sister agencies (e.g. Department of Child Services, Indiana State Department of Health); providing improved customer service through consistent, equitable, and user-friendly access to FSSA services including various public assistance programs such as SNAP, Medicaid, TANF (cash assistance), child care assistance, employment and training services for low-income clients as well as Medicaid eligibility throughout the State.

eSense staff is performing a feasibility study and alternatives analysis that includes cost/benefit analyses, risk analysis, and recommendations. This assessment will further detail the business and technical needs, costs, and risks associated with the viable alternative.
Key tasks performed by eSense on the project include:
• Provide business and subject matter expertise on public assistance programs administered by FSSA such as Medicaid, SNAP/Food Stamps, TANF.
• Conduct and document business modeling and requirements gathering sessions
• Document As-Is and To-Be processes.
• Gather business and technical requirements.
• Assess the current Indiana Client Eligibility System (ICES), evaluate alternatives, and develop a recommended strategic plan for the replacement of ICES.
• Prepare government procurement documents such as Request for Proposal, Request for Information, Cost Benefit Analysis, Cost Allocation Plans and documentation of Human Services applications, Advanced Planning Documents for Federal government agencies Centers for Medicare and Medicaid Services (CMS) and Food and Nutrition Service (FNS) to receive and ensure continued federal funding of the project.
• Create and maintain IT documentation such as instructional guides, reference manuals, job aids such as systems and technical design templates, handbooks, reports, proposals, and brochures.
• Provide expertise in Human Service business function(s) and the corresponding technical strategies, benefits, risks, and costs that impact the business as part of a procurement or RFP response.
• Develop, with State assistance, performance-based contracting strategies.
• Coordinate the procurement process by writing thorough and detailed RFP(s), documenting evaluation procedures, and assist in negotiating contracts with successful bidders.

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Medicaid Management Information System (MMIS) - Quality Assurance

Key tasks performed by eSense staff on the project include:
• Create, prepare and implement systems quality assurance reviews for numerous applications.
• Contribute to development of testing strategies.
• Consult with users, providing advice and direction.
• Perform more complex analysis of business requirements and system specifications.
• Coordinate testing activities on projects.
• Create test plans and scripts for own projects.
• Lead/review test plans written by others.
• Perform moderately complex to complex test data conditioning, regression testing and testing validation.
• Provide specific guidance on defects to developers.
• Give direction to less experienced analysts.
• Log, track, and verify resolution of software and specification defects.
• Documents all phases of the Systems QA process.

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Indiana Dept of Transportation - Quality Assurance

Key tasks performed by eSense staff on the project include:
• Improve Quality Assurance and testing efficiency and improve the quality of our key and enhancement applications.
• Analyze the way MIS Quality Assurance Testing is performed today and recommend procedure improvement changes to QA processes and practices.
• Identify and resolve problems or research out of the box tools to perform testing, develop creative solutions as necessary.
• Ensure delivery of INDOT applications, to help support and improve INDOT QA Testing processes.
• Ensure that MIS technology application objectives are delivered according to business owner requirement specifications.
• Review IINDOT’s current practices and research possible QA tools to make recommendations to the Management Information Systems Division.
• Create compatibility tests with vendor-provided programs.
• Evaluate proposed software or software enhancement for feasibility.
• Help setup monitoring of program performance after implementation to identify operating problems and ensure efficiency of operation.

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Illinois - Dept of Insurance - Health Benefit Exchange

Key tasks performed by eSense staff on the project include:
• Our staff is helping the Illinois Dept of Insurance to establish the technical and operational planning and development of an American Health Benefits Exchange, as authorized by the federal Affordable Care Act (ACA).
• Perform the requirements analysis, design, structure, organization, and maintenance of data from project inception through implementation of the system.
• Provide leadership and direction regarding all areas of data in the highly complex system that will be developed.
• Design, implement and maintain the development environment, the testing environment and the production environment.
• Develop a vision and data strategy for successful system integration and development.
• Define how the data will flow to and from the system to be designed.
• Create, monitor, and maintain complex relational databases.

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