Specifications include, but are not limited to: A. Staffing 1. The Contractor shall designate individuals as “key personnel,” subject to Agency continued approval. The Agency reserves the right to interview any and all candidates for named key positions prior to approving the personnel. Special requirements for key personnel are as follows: a. Account Manager. Responsible for the overall service delivery of the team, complying with contractual requirements and meeting the Agency’s expectations. The Account Manager shall be responsible for Contract compliance and general project oversight. The Account Manager shall represent the Contractor and be the primary liaison with the Agency. Minimum qualifications include: i. Three years of experience in account management or major supervisory role for a government or private sector as a healthcare payer, including a minimum of three years of experience in a state of equivalent scope to Iowa. ii. Bachelor’s Degree or at least 4 years relevant experience to the position. iii. Previous management experience with Medicaid, specifically in third party liability, recoveries, and knowledge of HIPAA rules and requirements is desired. b. Transition Manager. Responsible for facilitating all planning and operational readiness activities necessary to ensure a successful transition. This position will no longer be required once the Contractor has successfully transitioned to operations. The Transition Manager may also serve as the Account or Operations Manager. Minimum qualifications include: i. Three (3) years of experience in account management or major supervisory role for government or in the private sector as a healthcare payer or provider. ii. Bachelor’s Degree or equivalent relevant experience to the position. c. Operations Manager. Responsible for day-to-day project management and supervision. Minimum qualifications include: i. Four years of experience managing third party liability operations in a healthcare environment similar in scope and volume to the Iowa Medicaid Program. The experience shall include third party liability identification and verification, recoveries, quality management, and knowledge of HIPAA rules and requirements. ii. Bachelor’s Degree or equivalent relevant experience to the position. 2. Named key personnel shall: a. Be committed to the project full time and co-located with Agency staff at the Iowa Medicaid permanent facility in Des Moines, Iowa; b. Be available during Business Hours to respond to questions and concerns related to the Contract, except for routine absences or participation in required off-site meetings. Account Manager and Operations Manager positions are required to communicate absences with the Agency contract manager and provide suitable coverage during extended absences; c. Provide policy advice and support to the Agency and participate in meetings with the Agency as subject matter expert; d. Prepare and present status updates periodically to the Agency and other stakeholders, as requested by the Agency; e. Comply with all timelines in the Agency-approved project work plans; and f. Develop and maintain a plan for job rotation and knowledge transfer to ensure that all functions can be adequately performed during the absence of key personnel for vacation and other reasons. Any planned absences of key personnel shall be immediately communicated to the Agency. The Contractor shall ensure staff are trained and able to perform the functions of sensitive positions when the primary staff member is absent. g. One or more of the managerial staff shall have experience in security and privacy to include the following: i. Health Insurance Portability and Accountability Act (HIPAA) ii. National Institute of Standards and Technology (NIST) iii. Personal Health Information (PHI) iv. Personally Identifiable Information (PII)
