Start Date: ASAP Type: Temporary Project Estimated Duration: 12+ months with possible extensions Work Setting: hybrid, 25% onsite and 75% remote Only candidates able to relocate as required should apply to avoid removal from future consideration.
Required:
Experience with CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) compliance implementation;
Experience with FHIR APIs, including cloud-hosted FHIR API servers supporting FHIR version 4.0.1 or greater;
Experience with SMART on FHIR authorization and application framework (OAuth 2+, OpenID Connect 1+);
Experience with FHIR implementation guides including CARIN IG for Blue Button, US Core IG, and Da Vinci IG;
Experience with Patient Access API, Provider Access API, and Payer-to-Payer API implementation;
Experience with health plan data including claims, encounters, clinical data (USCDI v1+), and drug formulary data;
Experience with identity verification, consent management, and member authentication systems;
Experience with Medicaid, Medicare Advantage, or Federally Facilitated Exchange health plan systems;
Experience with third-party API developer portals, sandbox environments, and third-party application security risk assessments;
Experience with requirements traceability matrices (RTM) and formal project implementation methodologies;
Experience with state government or Medicaid Management Information Systems (MMIS) integration.
Responsibilities include but are not limited to the following:
Implement and support Patient Access API, Provider Access API, and Payer-to-Payer API solutions compliant with CMS-9115-F and CMS-0057-F requirements;
Configure and maintain cloud-hosted FHIR API infrastructure including façade data models, data maintenance timeframes, and 99.9% system availability standards;
Implement consent and identity management system including SMART on FHIR authorization, OAuth 2+/OpenID Connect integration, and member consent tracking;
Manage third-party application registration, onboarding, attestation, security risk assessment, and developer support portal;
Develop and execute project plan, requirements documentation, test plans, and system/integration testing including user acceptance testing prior to go-live;
Provide ongoing system maintenance, incident and error reporting, software improvements for regulatory compliance, and technical support;
Deliver training and self-service training materials for staff during implementation and on an ongoing basis as new features are released;