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Is this a Project or Program specific request (e.g., Connections, SFS)? Yes
If yes, please list the Project or Program Name: Billing Modifications and Enhancements – Managed Care & TPHI
Comprehensive Billing System (COBS)
Uniform Billing System (Banking)
OMH initiatives/projects as needed.
Please provide a short description of the project:
Modify IDMS/ADS based billing applications which incorporate multi-system data feeds to bill a variety of payers including managed care Medicare & Third Party Health Insurance (TPHI) for services rendered.
Please provide a full listing of the day to day tasks to be performed by the Consultant (be descriptive and specific):
Daily Tasks will include but not limited to the following:
1. Use IBM COBOL, JCL, CA-IDMS, CA-ADS to develop/maintain batch/online applications in an IBM z/OS environment. Perform analysis, design, coding, and testing of changes based on State/Federal mandates or requests from the OMH State Operations Finance Group.
2. Support Managed Care and Fee-For-Service billing of Medicare, Medicaid, & Third Party Health Insurance (TPHI), as well as for individuals (private parties). Monitor batch production jobs, analyze results, and address any aborts/system failures as needed.
3. Maintain/support encryption of mainframe data as needed using ASPG MegaCryption.
4. Maintain/support multiple batch based data feeds/exchanges between Oracle and IDMS environments.
5. Work with members of the Billing unit, DBA unit, and the office for Information Technology Services to migrate batch and online application changes to the QA and Production platforms following standard migration procedures.
6. Work with business owners, users, and technical support staff to identify changes that are needed and the solution for implementing them.
7. Respond to Client Service Center Help Desk calls assigned to Billing group.
Which Service Group is required?
What is the number of staff being requested? (maximum of 5) 1
Which Job Title Category is required?
Which Skill Level is required?
Which Skill Demand is required?
How many Candidate Response Forms are being requested per Contractor per position? (1 or 2) 1
When is the Target Start Date?
(30 Business Days minimum from date of request) November 14, 2018
How long is the engagement? (in months) 24
When is the estimated completion date? November 13, 2020
Is this a Full or Part-Time Position (Full time is considered 40 Hours Per Week)? Full
If Part-Time, enter approximate number of hours per week: N/A
What are the daily work hours? (note if negotiable or list preferred start and end time): 8 hour days with start time at or after 7:30
Where is the Home Base Region?
Where is the work office located? Enter Building Name (if known) Full Street Address, City, and ZIP Office of Mental Health/ITS
44 Holland Avenue
Albany, NY 12229
What type of software is typically used by the Agency? (e.g., Agency is an "IBM shop.”) IBM COBOL, JCL, CA-IDMS, CA Easytrieve, Microsoft
Office, Oracle, Toad, VB.NET
What type of hardware is typically used by the Agency? (e.g., Agency is a "Client shop.”) Dell and Client
Position Mandatory Qualifications
Analysis, design, coding, component and assembly testing of all application code owned by the Application Team.
Maintenance (including production support), enhancement and development work.
Write application software, data analysis, data access, data structures, data manipulation, databases, design, programming, testing and implementation, technical and user documentation, software conversions
Expert 84+ Months
Candidate is able to provide leadership of large teams and/or extensive industry experience and is considered at the top of his/her field.
84 months Demonstrated experience developing and maintaining mainframe batch programs using IBM COBOL to add, modify, process data in a mainframe database management system such as CA-IDMS.
84 months Demonstrated experience with developing/ maintaining a billing system(s) that bills Medicare, Medicaid, & commercial insurance for services rendered.
84 months Demonstrated experience working with Electronic Data Interchange (EDI) Health Insurance transactions. This includes but is not limited to the 837& 835 transactions.
84 months Demonstrated experience with IBM JCL utilizing utilities such as IDCAMS, IEBGENER, IEFBR14, SORT, etc.
6 months Demonstrated experience encrypting data with mainframe ASPG MegaCryption in an IBM z\OS environment.
60 months Experience working with PHI and HIPAA in a complex health related organization.
36 months Demonstrated experience with ORACLE performing functions such as writing complex queries, creating packages, stored procedures, functions, & tables.
Additional Information Requests:
Are there additional security requirements for the Authorized User? Mandatory ITS Security Agreements, HIPAA and OMH Confidentiality and Non-Disclosure Agreement (CNDA)
Will additional training possibly be required during the Engagement? Yes
If Yes, provide description of anticipated training. Candidate will attend all New York State/GOER and Agency mandated training programs, including Internal Controls, Prevention of Workplace Violence, Sexual Harassment Prevention, Information Security
What type, or manner, of Knowledge Transfer is requested during the engagement? During the term of this assignment, knowledge transfer from the consultant/project team to State employees will be mandated. The knowledge transfer plan will be a written plan with details determined by the State Project Manager in collaboration with the selected contractor according to the specific program needs.
Is travel anticipated during the Engagement? No
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