The following Enterprise Information Architecture principles support of the Vermont HSE Platform: Manage Information as an Enterprise Asset: Coordinate the collection, consolidation, and consumption of enterprise information to support strategic initiatives requiring the consistency and dependability of data across multiple business processes and throughout the entire life cycle of the information. Enable Data Sharing via Standards-Based Approach: Vermont’s HHS Agencies will provide and benefit from consistent and accessible data sharing, internally and externally, using appropriate Health IT standards for naming, messaging, and data exchange. Data Governance will be Transparent and Consistent: The Vermont HSE Platform will ensure that data governance processes decisions are consistently implemented across the organization to ensure that data integration is as effective as possible. Establish a Single Data Source approach to Client and Provider Information: The Vermont HSE Platform will use enterprise wide to provide reliable and cost-effective data sources for the records managed by each Agency and their partners. Continuously Improve Data Quality: Data will be continuously reviewed and there will be a relentless focus on ensuring the highest quality of data content with specified data owners accountable for quality and establishing standards for data stewardship — Addressing data definition, transformation, integrity and quality issues. Enforce Data Confidentiality and Legal Requirements: AHS will ensure that all rules and regulations that govern data collection, storage and use are rigorously applied. The following Enterprise Technology Architecture principles support the Vermont HSE Platform: Integrated and Accessible Architecture: Information captured across the program silos need to be integrated and accessible. Leverage data across systems and processes, taking into account security, privacy and confidentiality considerations. Maintain consistent definitions and a single authoritative source of record for data. Robust Infrastructure Capabilities: Enhance infrastructure capabilities for standardized approach to health information. Need to deploy IT infrastructure for user driven access to and analysis of information. Privacy and Security Compliance: Ensure privacy and security of participant information in accordance with legislative mandates (e.g., and community preferences. Improve and enforce the Security standards around Identity and Access Management (IAM).
Oversees clinical management of all PBM programs and resources including the prior authorization program, preferred drug list, clinical criteria and protocols in the call centers, drug rebate programs, utilization management and drug utilization review programs Mentors pharmacy interns during experiential rotations Provides drug information needed to support the Department’s clinical initiatives and clinical recommendations as needed. Provide assistance to and Vendor staff on Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) coding matters pertaining to drugs Monitor drug utilization trends and make clinically and financially sound recommendations to the State Support prospective (pro-DUR) and retrospective drug utilization review activities and provider communications Provide DUR Board coordination and support Acquire, analyze, and present information regarding pharmacy benefit management “best practices” Analyze utilization data, authorization data and other clinical program data to assess the need for changes Support drug appeals as directed by the State Provides support to resolve provider issues Is expected to work on site with Department Experienced in clinical pharmacy program management, DUR, formulary/PDL development, and Medicaid manufacturer drug rebate administration including Federal and supplemental rebates Extensive knowledge of claims processing systems (including Medicaid), utilization management programs, and drug information systems Drug information specialist Vermont-licensed pharmacist in good standing or licensed in another state and eligible for Vermont licensure Data Analyst Responsible for all State data requirements and reporting needs including those that exceed the standard reporting package and the information available through the decision support tool provided by the Vendor Provides ad hoc reporting as requested by Pharmacy Benefits Management Extensive knowledge of Medicaid claims processing, data management, pharmacy practices, and the Vermont Medicaid program Deep familiarity with data structures of the Vendor’s technology
Task 0 — Project Monitoring and Status Reporting Deliverable 0 — Project Status Reporting (Recurring throughout the length of the project) Implementation Task Related Deliverables The following table provides a list of deliverables that will be created by the Vendor during implementation. The state encourages responders to use industry best practices for project management and describe their recommended approach. Task Related Deliverables Task Deliverable Task 1 — Project Initiation and Planning Deliverable 1 — Project Kick-off Presentation Deliverable 2 — Project Management Plan Deliverable 3 — Project Work Plan and Schedule Deliverable 4 — Monthly Project Status Reports Task 2 — Requirements Validation Deliverable 5 — Requirements methodology and Template Deliverable 6 — Cross-Walk of RFP Functional against Legacy System Functionality Deliverable 7 — Detailed Functional and Non-Functional Requirements Traceability Matrices Task 3 — System Design Deliverable 8 — Configuration Design Document Deliverable 9 — Data Integration and Interface Design Document Task 4 — Configuration and Development Deliverable 10 — Client Review of Configuration Deliverable 11 — Unit Testing Scripts and Results Task 5 — Testing Deliverable 12 — Documented System Test Results Deliverable 13 — User Acceptance Task 6 — Training Deliverable 14 — Training Plan Deliverable 15 — Training Materials Deliverable 16 — Documented Evidence of Successful End-User Training Task 7 — Deployment Deliverable 17 — Deployment Plan Deliverable 18 — CMS Certification Deliverable 19 — System Documentation Deliverable 20 — Performance SLAs Deliverable 21 — Rollout Deliverables Expectations Document (DED) The Vendor must develop Deliverables Expectations Documents (DEDs), in an approved State form and format; project deliverables need to adhere to the information within the DED. No work will be performed by the Vendor on any deliverable until the
Process Flows: A diagram depicting the set of activities required to perform a specific function in the future state. Proposal: An offer from the State requesting specific services to a prospective Vendor. Q QA: Quality Assurance Quality of Service (QoS): The ability to provide different priority to different applications, or data flows, or to guarantee a certain level of performance to a data flow. R Relational Database Management System A Database Management System in which data is stored in the form of tables and the relationship among the data is also stored in the form of tables. Reach Up: Reach Up (TANF)in Vermont helps families with children by providing cash assistance for basic needs and services that support work and self-sufficiency. Requirements Traceability Matrix: RTM — Detailed list of requirements necessary for the proposed solution. RFP: Request for Proposal Rich Internet Application (RIA): Web application that has many of the characteristics of a desktop application, typically delivered either by way of a site-specific browser or via a browser plug-in. S SCHIP: State Children’s Health Insurance Program Service-Oriented Architecture (SOA): A set of design principles used in application development characterized by the following attributes: The system must be modular. This provides the obvious benefit of being able to "divide and conquer" — to solve a complex problem by assembling a set of small, simple components that work together. The modules must be distributable — that is, able to run on disparate computers and communicate with each other by sending messages over a network at runtime. Module interfaces must be "discoverable" — that is, clearly defined and documented. Software developers or generate interface metadata that specifies an explicit contract, so that another developer can find and use the service. A module that implements a service must be "swappable." This implies that it can be replaced by another module that offers the same service without disrupting