Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsThe account manager, including Team Noridian's executive management when necessary, determines themost effective method to correct and prevent reoccurrence of performance issues and defines thenecessary actions to take. These actions are framed by outlining the actionable steps, the projected impactof those steps, and the projected resolution timeframe.All CAPs are subject to Department approval and are presented to the Department for review prior tobeginning the work on any CAP. Team Noridian will work with the Department to discuss and develop atimeline for the CAP to be implemented and if the CAP results in system changes, we will execute theCAP using our established systems development life cycle (SDLC) methodology and changemanagement procedures. We track and report on the CAP through completion and immediately notify theDepartment of any problems with the implementation of the CAP. Once the issue is corrected, anevaluation of the CAP is conducted to identify lessons learned to be applied to future CAPs.7.3.1.2 Internal Quality Assurance ActivitiesRFP Section 5.3.1, Requirement bTeam Noridian brings the Department a comprehensive quality assurance (QA) program based onmanagement approaches developed over a long period of successful development, implementation, andlarge-scale claims processing operations. These approaches have proven effective in maintaining qualitylevels that consistently meet or exceed customer expectations, while continually adapting to the changinghealth care environment from that in which our quality program began. The adoption of our qualityprinciple, based on Noridian's corporate values, ensures our commitment to quality is at all levels of theorganization. Noridian's quality practices meet the requirements of the International Organization ofStandardization (ISO) 9001:2000 standard for quality management programs and stem from an ongoingfocus on quality that has evolved in over 70 years of health care administrative services.Team member CNSI's management and quality processes have been externally assessed at CapabilityMaturity Model Integrated (CMMI) Level 2 and are compliant with Level 3, with the official assessmentat Level 3 expected in 2012. CMMI is the industry standard for quality managed repeatable system lifecycle processes, and CNSI's commitment to CMMI is consistent and enhances Team Noridian’s qualityassurance approach.As part of our Core MMIS operations, Team Noridian will enhance its current internal QA program andassociated plan with guidelines, tasks, and activities designed to monitor all of our processes,deliverables, and procedures. This program will include the use of eCAMS, the next-generation claimsprocessing system, and OnBase, our document management and workflow system, which provides theability to automate quality control activities using business rules for random sampling.The independent Quality Monitoring and Control Unit will be responsible for measuring and reporting thequality, accuracy, and timeliness of all performance requirements including subcontractor performance.QA activities have been centralized within this unit to ensure consistency in establishing and measuringquality expectations across the organization. Quality improvement responsibilities are integrated tofacilitate process improvements based on objective measurements. The Quality Monitoring and ControlUnit communicates this information to the account manager, through the Project Management Office(PMO). The account manager is ultimately responsible for overall contract performance including TeamNoridian staff members and all subcontractors working on the project.Team Noridian fosters a culture of quality management and compliance which forms the basis for allwork activities. Quality is an expectation at all levels and is promoted through several mechanisms:• Routine staff management activities which focus on employee performance and each employee'scommitment to quality• Monthly one-on-one meetings between management and staff to discuss individual performanceand quality7 | 19