Iowa Medicaid Enterprise (IME)

Brief Description: The IME is a completely new concept for a state Medicaid Department.The State of Iowa has taken a radical approach to their Fiscal Agent procurement, utilizing a "Best of Breed" approach. The State of Iowa needed a highly competent project management partner with extensive experience in Medicaid processing and HIPAA compliance to assist them with over 49 key activities needed to implement the IME.Through a highly competitive bidding process, the Contract was awarded to SES in April, 2004.The IME vision is to contract with up to nine independent contractors for three systems components and six service components as well as State staff that became the IME, a fully functional Medicaid Department collocated under one roof starting in Fiscal year 2006 (July 1, 2005).

SES is 100% responsible for the establishment of the IME EPMO, including the development of policies, procedures and metrics regarding performance measurements, Independent Verification and Validation (IV&V) activities, the Business Rules Extraction Project, and the Workflow Logical Definition Project.Serena TeamTrak was used to track issues from inception through resolution.

Here is an extensive listing of key activities performed by SES in support of the IME: schedule and facilitate all project meetings related to the multiple components of the Master Work Plan (MWP).Monitor execution of the MWP, monitor risks, problems and resolutions, monitor Technical Compliance, Assess Planning documents, assess requirements, assess system analysis and design of enhancements and all connectivity, assess testing, develop project and CMS status reports, create and maintain an electronic Project Library, develop an issues database (Serena TeamTrak) to cover the MWP, proactively identify problems, review project deliverables, report on all performance measures of this contract each month, audit and verify that both Medicaid Management Information System (MMIS) systems produce identical results through June 30, 2005.

Additional key activities include all of the following: create detailed Master Work Plan and schedule to include all contract activities, including the IV&V activities and all activities of all phases of multiple, interconnected projects, including those of all Contractors for the IME, develop deliverable acceptance criteria, monitor transfer plans of Affiliated Computer Services (ACS), Information Technology Enterprise (ITE) and Department of Human Services (DHS)-Division of Data Management (DDM) to transfer a copy of the current MMIS to the State Data Center (SDC), monitor development of the Data Warehouse (DW), audit and validate all test results of the MMIS, perform code analysis of current MMIS system to determine system's business rules, determine if business rules are synchronized with IME policy, perform systems integration analysis and develop operational logic for workflow process management, create business process contract & monitoring system from workflow process management, audit and validate core MMIS workflow process management software for DHS approval, develop an electronic library of documentation including, but not limited to, the workflow process management system, desk manuals, systems documentation, forms, etc., to be maintained throughout the life of the contract and turned over to DHS for maintenance, develop and implement a master plan for connectivity for all IME contractors during Phase 2 and 3 of contract prior to co-location of IME, develop operational phase performance measures for ITE mainframe and ITE Data Warehouse activities, assist the Department in the development and execution of contracts for RFP MED-04-015, MED-04-034 and MED-04-036, coordinate workflow process management with all successful bidders, assess design and installation of infrastructure (DHS anticipated developing a Web Portal to facilitate communications with its providers as part of this project), and assess application software.

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