Work Model: Onsite Allows Relocation: Yes
SUMMARY/RESPONSIBILITIES The State of Mississippi Division of Medicaid (DOM) is actively implementing federal interoperability mandates under CMS-0057-F (Interoperability and Prior Authorization Final Rule). These rules require DOM to implement and maintain Patient Access APIs, Provider Directory APIs, Provider Access APIs, Payer-to-Payer APIs, and Prior Authorization APIs based on HL7 FHIR standards. DOM's interoperability environment relies on Infor Cloverleaf as the primary integration engine, MarkLogic as the data store, and FHIR-based APIs for data exchange with multiple external partners including managed care organizations (MCOs), providers, payers, and state and federal agencies. DOM exchanges health data with multiple external sources and maintains a complex portfolio of HL7 and FHIR-based healthcare interfaces. These interfaces require ongoing management, optimization, documentation, and governance to ensure accurate, reliable, and compliant data exchange. Existing interfaces require a comprehensive current-state assessment, standardized documentation, and a structured process improvement program to ensure they meet current standards and are optimized for performance and reliability. The purpose of this Statement of Work (SOW) is to procure staff augmentation services for one (1) Lead Interface & Interoperability Analyst to provide senior-level technical leadership for DOM's healthcare interface operations, interoperability compliance activities, interface documentation and process improvement, document management, and small team leadership. The contractor shall report directly to the DOM Chief Information Officer (CIO), Director of Solutions, and/or Chief Technology Officer (CTO).
The contractor shall provide technical leadership and operational services across the following functional domains. The scope encompasses both ongoing operational responsibilities and active interoperability initiatives.
- Healthcare Interface Management & Operations a) Manage, monitor, and maintain HL7 and FHIR-based healthcare interfaces across DOM's integration environment, ensuring availability, accuracy, and reliable data exchange. b) Oversee the Infor Cloverleaf integration engine, including interface configuration, message routing, transformation, error handling, and performance tuning. c) Interpret, refine, and optimize existing interfaces to improve data accuracy, reliability, processing throughput, and operational efficiency. d) Triage and resolve interface failures, message errors, and data exchange issues in a timely manner consistent with incident severity levels. e) Coordinate with external trading partners, including MCOs, providers, payers, and state and federal agencies, on interface connectivity, onboarding, and issue resolution.
- Interoperability & Regulatory Compliance a) Support DOM's compliance with CMS-9115-F (Interoperability and Patient Access) and CMS-0057-F (Interoperability and Prior Authorization) final rules, including all applicable FHIR API implementation requirements. b) Support FHIR API implementations including Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs. c) Ensure interfaces and data exchange processes align with HL7 FHIR standards, US Core Implementation Guides, Da Vinci Implementation Guides, and USCDI data element requirements. d) Coordinate with AWS, MarkLogic, Cloverleaf, and other vendor and platform teams on interoperability solution delivery and technical issues. e) Keep current with CMS interoperability regulations and advise DOM IT leadership on compliance implications, required actions, and implementation timelines.
- Interface Documentation & Process Improvement a) Develop and maintain comprehensive documentation for all healthcare interfaces, including interface specifications, data flow diagrams, mapping documents, message type inventories, and standard operating procedures (SOPs). b) Conduct a current-state assessment and evaluation of all existing interfaces to determine whether they are up to standard, optimized, and properly documented; identify and prioritize gaps. c) Map and document all HIPAA-covered interfaces, including data sources, destinations, message types, exchange frequency, and data elements exchanged. d) Identify and implement interface process improvement, standardization, and automation opportunities to improve reliability and reduce manual operational burden. e) Develop and maintain interface runbooks, troubleshooting guides, and a knowledge base to support operational continuity and staff cross-training.
- Document Management Systems a) Implement, configure, and maintain document management systems supporting DOM's interoperability operations, IT governance, and compliance documentation requirements should DOM decide to implement a document management system. b) Establish and enforce document governance processes including version control, access management, naming conventions, retention policies, and compliance documentation standards. c) Organize and manage project artifacts, SOPs, interface documentation, and compliance records within document management platforms. d) Ensure document management practices align with HIPAA, CMS, and State of Mississippi records management requirements.
- Cloverleaf Configuration Migration a) Plan and support the potential migration of the Infor Cloverleaf integration engine configuration to a new infrastructure environment, anticipated within the next six (6) months. b) Develop migration plans, interface validation test strategies, and rollback procedures for all Cloverleaf configuration changes and migration activities. c) Coordinate with infrastructure, network, and vendor teams to ensure the migration is executed with minimal disruption to interface operations and trading partner connectivity. d) Validate all interfaces post-migration to confirm data integrity, message accuracy, and full operational continuity for all trading partners and data exchange flows.
- Team Leadership & Coordination a) Lead and coordinate a small team of contractors focused on interoperability and data movement between applications, providing technical direction, mentorship, and day-to-day work assignment. b) Conduct interface configuration and code reviews, quality assurance reviews, and peer review of teamwork products to ensure accuracy and adherence to standards. c) Facilitate team meetings, coordinate status reporting, and serve as the primary technical liaison between the interoperability team and DOM IT leadership. d)Manage team workload, priorities, and deliverable timelines; escalate resource or scope conflicts to DOM leadership as appropriate.
DOM Technology Environment The following platforms, tools, and systems comprise DOM's current and target-state technology environment. The contractor will be expected to work within this environment and should possess a general understanding of the types of technologies listed below. Direct experience with specific platforms is preferred but not required; the ability to learn and adapt to new tools within a reasonable onboarding period is acceptable.
- Integration & Interoperability Platforms: DOM's interoperability environment is built around healthcare integration engines and data exchange standards. The contractor will work with platforms such as Infor Cloverleaf for HL7 and FHIR message routing and transformation, MarkLogic as a NoSQL data store supporting clinical and provider data, and standard healthcare messaging protocols including HL7 v2.x and HL7 FHIR. Experience with any major healthcare integration engine (e.g., Cloverleaf, Rhapsody, MuleSoft, InterSystems, or similar) is valued.
- Cloud & Infrastructure Platforms: DOM's infrastructure is primarily hosted on Amazon Web Services (AWS), with Microsoft Azure / M365 supporting identity services, enterprise productivity, and collaboration tools including SharePoint, Exchange Online, and Teams. Familiarity with cloud-hosted environments is expected; specific AWS and/or Azure experience is a plus.
- Authentication & Security: DOM utilizes modern identity and access management platforms including Okta and Auth0 for API and user authentication. FHIR API environments leverage OAuth 2.0 and SMART on FHIR authentication frameworks. A general understanding of identity management concepts and standards-based authentication is expected.
- Collaboration & Project Management: Day-to-day project coordination and documentation are managed through tools such as Smartsheet for project tracking, Microsoft SharePoint for document management, Microsoft Teams for communication, and GitLab for source code and configuration management. The contractor should be comfortable working within standard enterprise collaboration and project management toolsets.
Key Duties
The contractor shall perform the following duties on an ongoing basis:
- Manage daily healthcare interface operations, ensuring availability, accuracy, and performance of all data exchange processes across Cloverleaf and FHIR API environments.
- Monitor, triage, and resolve interface errors, message failures, and data exchange issues; coordinate with trading partners as needed to restore normal operations.
- Develop and maintain comprehensive interface documentation including interface specifications, data flow maps, SOPs, and operational runbooks.
- Continue current-state assessment of all existing interfaces; identify and implement optimization opportunities to improve performance, reliability, and standards compliance.
- Support CMS-9115-F and CMS-0057-F compliance activities including FHIR API testing, validation, documentation, and go-live support.
- Coordinate with external trading partners, including MCOs, providers, and payers, on interface onboarding, connectivity, and issue resolution.
- Lead and manage the interoperability contractor team; assign work, review deliverables, provide technical direction, and report team status to IT leadership.
- Implement and maintain document management systems and governance processes for interoperability and IT operations documentation if DOM procures a solution.
- Plan and execute Cloverleaf configuration migration activities, including coordination with infrastructure and vendor teams, validation testing, and post-migration verification.
- Prepare and deliver status reports to IT leadership summarizing interface operations, open issues, project progress, and team activities.
- Participate in interoperability project meetings, vendor coordination calls, and CMS compliance reviews as required.
- Develop and maintain interface standards, naming conventions, and best practices documentation to support operational consistency across DOM's integration environment.
Security and Compliance Requirements
- The contractor shall pass a background investigation as required by the State of Mississippi and DOM prior to commencing work.
- The contractor shall comply with all HIPAA Privacy and Security Rule requirements, including safeguarding of Protected Health Information (PHI) and electronic PHI (ePHI) encountered in the course of interface operations and data exchange activities.
- The contractor shall comply with CMS Acceptable Risk Controls for Automated Medicaid Program Eligibility (ARC-AMPE) and all applicable federal security requirements.
- The contractor shall adhere to Mississippi ITS security policies, standards, and procedures applicable to Medicaid systems and data.
- The contractor shall complete all required security awareness training within thirty (30) days of onboarding and annually thereafter.
- The contractor shall execute a Non-Disclosure Agreement (NDA) and any additional confidentiality agreements required by DOM.
- The contractor shall not remove, copy, or transmit DOM data, documents, or systems information without prior written authorization from DOM.
- Upon termination or completion of the engagement, the contractor shall return all DOM property and all credentials and system access shall be revoked the last day of employment.
QUALIFICATIONS
Required:
· Ten (10) or more years of progressive healthcare information technology experience with direct, hands-on experience in HL7 and/or FHIR-based healthcare interfaces. Any combination of HL7 v2.x and HL7 FHIR experience totaling ten (10) or more years is acceptable. · Demonstrated experience with healthcare integration engines, preferably Infor Cloverleaf, Rhapsody, or equivalent enterprise integration platforms. · Strong understanding of healthcare data standards including HL7 v2.x, HL7 FHIR R4, CDA, CCDA, X12, and USCDI data element requirements. · Experience with healthcare interoperability in a Medicaid, managed care, hospital/health system, or HER environment. · Experience with EHR interfaces and clinical data exchange. · Demonstrated experience implementing and maintaining document management systems and establishing document governance processes. · Experience leading or supervising technical teams or contractors, including work assignment, quality review, and performance oversight. · Strong understanding of HIPAA Privacy and Security Rule requirements as they relate to healthcare data exchange and interface operations. · Experience with interface documentation, data flow mapping, and interface process improvement. · Excellent written and verbal communication skills, including the ability to create technical documentation and present findings and recommendations to IT leadership audiences. · Master's degree in Information Technology, Health Informatics, or a related management or technology discipline.
Preferred:
· Experience working in state or federal government IT environments, preferably within a Medicaid, healthcare, or human services agency. · Direct experience supporting CMS interoperability mandates including CMS-9115-F and CMS-0057-F, including FHIR API implementation and compliance documentation. · Experience with Infor Cloverleaf configuration, administration, and environment migration. · Experience with MarkLogic or similar NoSQL databases in a healthcare data management context. · Experience with FHIR API development, testing, or implementation including US Core and Da Vinci Implementation Guides. · Experience with SMART on FHIR and OAuth 2.0 authentication frameworks for FHIR API access management. · HL7 certification or equivalent industry credential in healthcare informatics or integration. · Experience with corporate or enterprise document management platforms. · Experience with cloud platforms, particularly Amazon Web Services (AWS), in a healthcare or government context. · Project Management Professional (PMP) or similar project management certification. · Experience with CMS ARC-AMPE security requirements and Medicaid system security compliance.
PRE-EMPLOYEMENT & CLIENT SUBMISSION REQUIREMENTS
Employment and/or client submission is contingent upon successful completion of required pre-employment screening and verification processes. These requirements include:
• Background check: Candidates must successfully complete the required background screening in accordance with company policy and applicable law.
• Drug screening: Candidates must successfully complete the required drug screening in accordance with company policy, applicable client requirements, and applicable law.
• Identity and location verification: Candidates may be required to complete identity and/or location verification using a secure verification tool prior to client submission.
• Employment eligibility: Candidates must provide appropriate documentation to verify employment eligibility as required by law.
• Qualification verification: Information provided during the application and recruiting process, including employment history, education, certifications, licenses, and professional references, may be verified as applicable.
• Additional client requirements: Additional screening, documentation, or verification may be required based on the client, position, work location, or applicable requirements.
All screening and verification activities will be conducted in accordance with applicable company policies, client requirements, and federal, state, and local laws.
BENEFITS
This is a contract opportunity with a great organization. As a contractor for Smith Johnson, you are eligible for medical, dental, life, disability. Smith Johnson pays for 70% of your medical and dental and 100% of life and disability. The contract is also eligible for PTO/holiday accrued monthly. You are also eligible for a 3% retirement matching plan. Smith Johnson believes in taking care of our contractors.
