Business Systems Consultant IV

The Office of Information Services (OIS) is a shared service provider for the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS). OIS provides the technology systems and services that support more than 18000 OHA and ODHS agency staff at local offices and facilities around the state. These systems and services help the two agencies determine client service program eligibility; provide medical housing food and job assistance; provide addiction mental health vocational and rehabilitative services; protect children seniors and people with physical and/or developmental disabilities; process claims and benefits; manage provider licensing and state hospital facilities; and promote and protect the state public health.

OIS/ OHA are seeking an experienced Business Systems Consultant with expertise in data system analysis and evaluation and advanced communication skills to provide project management support data system evaluation and improvement support including the documentation of improvement recommendations business and technical requirements and test cases and delivery of testing support in accordance with business data security and regulatory requirements.

Background and scope of project:

HAL is a Medicaid analytical and reporting SQL database solution and environment managed by the MADI (Medicaid Analytics and Data Integration) Unit housed within the Office of Health Information Technology and Analytics Infrastructure that exists within the Health Policy and Analytics (HPA) Division of the Oregon Health Authority (OHA).

Medicaid administrative data is primarily made up of 1) medical claims submitted by health providers and Coordinated Care Organizations (CCOs) to receive payment for health services delivered to patients enrolled in Oregons Medicaid program which is known as the Oregon Health Plan (OHP) and 2) Medicaid enrollment data from the OHA/ ODHS ONE eligibility system. The raw transactional data are stored in Oregons Medicaid Management & Information System (MMIS). HA analysts typically access these data through a MMIS data warehouse solution called Decision Support and Surveillance Utilization Review System (DSSURS) or in the Health Analytics Library (HAL) where the raw Medicaid enrollment and utilization/ claim data are packaged differently into easier to analyze categories and groups for analysis. These analytical valueadded elements are not present in DSSURS.

HAL contains Medicaid enrolment and claims data that is accessed by two main sets of users:

OHAs Office of Actuarial and Financial Analysis (OAFA) team users who use the data for setting of percapita rates of reimbursement of health care services provided by Coordinated Care Organization (CCOs) to Oregons Medicaid population and various other financial analyses.

Office of Health Analytics reporting teams who access Medicaid enrollment and claims data for the development of different enrollment and utilization analytical and data visualization products.

The HPA MADI unit wants to launch a HAL modernization project to analyze identify and make improvements to the HAL analysis and reporting database solution. This project has the following objectives:

Analyzing the existing HAL database solution and environment identifying any refinements or rework to HAL architecture dataflows governance or management processes and developing a roadmap for HAL future state.

Reprogramming HAL ETL code currently written in legacy SAS language into SQL language to prepare HAL for migrating to the OHA ODE (Oregon Data Environment) cloud Azure environment (NOTE: The migration to the cloud expected to occur in the next 12 years is out of scope for this project and will require working with OIS and other OHA teams)

Gathering and documenting requirements developing and testing other improvements to the HAL data logic including:

o Updating claim data grouping categories used predominantly by the Office of Actuarial and Financial Analysis (OAFA) team for rate capitation analyses to reflect updates Medicaid national coding standards.

o Performing other coding improvements needed by OAFA team users and other HAL users to improve analytical value and capabilities of HAL data or reflect changes in Medicaid eligibility program beneficiary and claim administrative coding these types of improvements have accumulated over time and have reached a point in which they require a focused project and dedicated resources.

Tasks:

Contractors Key Person shall work with various OHA program areas and business teams and OIS staff as needed performing the following tasks:

• Provide project management support such as writing project status and other written reports and presentations covering analysis and recommendations for agency project team/ project governance committee communication materials etc.
• Lead and perform HAL data system analysis and evaluation work including:

o interviewing system users and system management teams to inquire about system issues and gaps

o reviewing documentation and analyzing current HAL system/ environment including data models schemas and tables data dictionaries ETLs system and database management processes data quality security queries reporting environment etc.

o documenting existing data/system architecture data flows description of schemas tables and fields

o identifying and describing current issues and areas for improvement

o providing or developing system improvement reports and recommendations.

o documenting prioritizing and presenting improvement recommendations

o developing a strategic roadmap for data system improvement efforts.

• Work with OHA project team members (PM BAs DBAs data analysts architects) and HAL users to determine business/technical requirements evaluate and recommend specific data design options
• Gather and document detailed system data and integration requirements for HAL system improvements (e.g. changes to business rules ETL code HAL tables new or updated OHG Medicaid claim code grouping categories etc.)
• Develop test cases scripts and test datasets.
• Perform system/ data testing analyze and document test results.
• Develop or update data management standards and processes to inform business area system improvement and deployment activities and train OHA staff in the application and use of these standards and processes.
• Organize develop and update system process and training materials to help educate HAL users about data management best practices and usage of BI tools to analyze and report data stored in HAL.

Required skills and experience:

Excellent written/ oral communication skills.

• Advanced data analysis skills.
• Analytical problemsolving skills.
• Working knowledge of SDLC.
• Proficient in the use of Microsoft Office suite tools.

In addition the ideal candidate will have skills and experience in:

• Knowledge of Medicaid administrative data and eligibility requirements.
• Knowledge of project management principles.
• Business analysis techniques especially in gathering and documenting business and technical requirements.
• Project management tools like Smartsheet.
• Attention to detail.

Covendis rate card description for a Business Systems Consultant IV:

Fulltime professional Information Technology Project Development work experience and/or Function/Business Process Analysis work experience.

Substitutions: Accredited college training may substitution for the required work experience with a maximum substitution of four (4) years. (Fifteen (15) semester hours in Information Technology or a related area is required.)

Accredited graduate training in Business Administration Information Technology or a related area may substitute for the required work experience with a maximum substitution of two (2) years. (Fifteen (15) semester hours in Information Technology or a related area is required in either the undergraduate or graduate training).

Successfully completion of an Information Technology Certification program may substitute for the required work experience with a maximum substitution of two (2) years. (Proof of certification must accompany application.)

Two (2) years of work experience as a Project ManagerAssociate ; Quality Assurance Senior Analyst ; Business Systems ConsultantIntermediate ; Quality Assurance Analyst may substitute for all of the required experience

Our primary criteria are the qualifications and experience of the proposed key person. Please propose your strongest candidate at a rate less than or equal to the maximum.

Interviews will be conducted via MS Teams. Interview times will reflect Pacific Standard Time.

Due to circumstances beyond our control we anticipate two weeks or more for the background check completion for the selected candidate.

This contractor position is approved for remote/hybrid/onsite work.

Onsite/Remote onboarding will be required for the first day.

The selected key person could potentially telecommute as agreed to between the Agency Authorized Representative and the key person. Any decision to allow telecommuting is made with the understanding that decision will be reevaluated by the Agency Authorized Representative on a regular basis. The key person should be available to work onsite within a reasonable timeframe.

Telecommuting will be contingent upon the key person providing their own adequate computer monitor(s) Internet connection and telephone and be readily available during normal working hours via phone email and instant message applications. Access to Agency systems will be provided via VPN or similar software. No hardware or additional software will be provided at the key persons home site or their PC.

For Services that are agreed to occur remotely that those Services will only be completed by the Key Person resourced for the Project and all work must be performed in the United States of America. Remote engagement requires Key Person to have consistent access and/or clarity for: high speed internet cellular phone/landline phone web camera and microphone.

OIS and OHA operate on standard business days (Monday Friday 8 AM 5 PM Pacific Standard Time except for State of Oregon holidays and business closures) and Key Person must be available to engage with OIS/OHA as agreed upon with OIS and OHA management.