Government Contract | Maryland
Medicaid Quality Analyst

Bid Information

Bid Alert No: 00000447692

Bid Title: Medicaid Quality Analyst

Agency Bid No. Title: 620048

Received Date: 12/23/2015

Close Date: 01/19/2016

Purchase Type: Term: 02/01/2016 - 12/30/2017

Delivery Point: Baltimore, Maryland

Delivery Date: Not Stated

Special Notices: Bidder Preregistration


Specifications include, but are not limited to:1. Support compliance monitoring, identify strategies to insure compliance with COMAR andthe federal Medicaid requirements of the School-Based Medicaid Program. Analyze andidentify service areas and providers with lower than average recovery of Medicaid revenueand assist with revenue maximization strategies. Provide technical guidance in areasincluding billing for new health related services, tracking of underreporting, and correctingdenied claims. Monitor changes in recovery at the provider level, track compliance by localschool system and local lead agency providers, support expansion of new Medicaidservices, and prepare summary reports;2. Examine, analyze and, interpret monthly Medicaid payments to local school systems, locallead agencies, nonpublic schools and other providers of health related services. Select paidclaims representing potential discrepancies and conduct detailed case studies at the childand provider level. Prepare discrepancy reports related to the Early and Periodic Screening,Diagnostic and Treatment (EPSDT) benefit and the Maryland Children's HealthProgram (MCHP). Examine service discrepancies distinguished high risk for COMARcompliance violations, and prepare reports;3. Recommend revision to rules, regulations, and procedures to support the expansion ofEPSDT for school-based services, and to support the 2016 regulatory changes to COMAR10.09.52 and 10.09.56;4. Review and analyze related Medicaid reporting structures: Medicaid compliance and datacapturing systems, Maryland On-Line Individualized Educational Program, SpecialServices Information System (SSIS), Medicaid self-monitoring, and Autism WaiverTracking Systems.5. Provide technical assistance and identify changes in software systems used to achieveefficiency in preparing the Level of Care, Plan of Care, and the Quality Assurance MedicaidMonitoring System. Provide training and technical assistance to service coordinators on theAutism Waiver Level of Care system. Collaborate with the software contractor on systemrevisions and test all changes before launching new versions of the Autism Waiver Level ofCare software. Test the new Autism Waiver Plan of Care software and providerecommendations on improvements. Provide technical assistance with the design of theAutism Waiver Quality Assurance Software.

Bid Related Documents

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Product Codes: 91878, 94610, 95327

Agency Information

Issuing Agency: State of Maryland - Department of Education

State: Maryland

Agency Type: State and Local

Contact: June Dwyer 200 West Baltimore Street, 2nd FL, Baltimore, Maryland, 21201

Phone: 410-767-0116

Fax: 410-333-8723




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