Queries and Reports accuracy and validity on an annual – Predefined and Ad-Hoc IV.N.4 Operations Phase - Must provide, implement, and Business Architecture maintain State approved Overview - Managing algorithms and supporting Queries and Reports documentation utilized within the – Predefined and Ad-Hoc DMA. Must provide, implement, and IV.N.4 Operations - maintain a approved Business Architecture Communication Plan regarding Overview - Managing DMA system and data events, Queries and Reports information on known data issues, – Predefined and Ad-Hoc and status updates. IV.N.4 Operations Phase - Must provide support services to Business Architecture provide, implement, and maintain Overview - Managing analytics and reports of complexity Queries and Reports levels outside the scope of State – Predefined and Ad-Hoc staff knowledge and training levels. Must provide a configurable IV.N.5 Operations Phase - that identifies potential Business Architecture incidents of fraud, waste, abuse Overview - Program Integrity and erroneous payments. Must develop, update and maintain an algorithm library throughout the life of the contract. New algorithms will be created by SState staff, the Contractor, and the program integrity field as the industry IV.N.5 Operations Phase - changes and as the nature of Business Architecture fraud, waste abuse, and erroneous Overview - Program Integrity payments evolves. Must authorized users to IV.N.5 Operations - create, modify, and run the rules Business Architecture and algorithms with limited or no Overview - Program Integrity technical support. Must incorporate link analysis of providers and members where relationships extend beyond IV.N.5 Operations Phase - provider to provider relationships Business Architecture (e.g. interwoven relationships Overview - Program Integrity between providers, members,
Queries and Reports – Predefined and Ad-Hoc accuracy and validity on an annual IV.N.4 Operations Phase - Business Architecture Overview - Managing Queries and Reports – Predefined and Ad-Hoc Must provide, implement, and maintain State approved algorithms and supporting documentation utilized within the DMA. IV.N.4 Operations - Business Architecture Overview - Managing Queries and Reports – Predefined and Ad-Hoc Must provide, implement, and maintain a approved Communication Plan regarding DMA system and data events, information on known data issues, and status updates. IV.N.4 Operations Phase - Business Architecture Overview - Managing Queries and Reports – Predefined and Ad-Hoc Must provide support services to provide, implement, and maintain analytics and reports of complexity levels outside the scope of State staff knowledge and training levels. IV.N.5 Operations Phase - Business Architecture Overview - Program Integrity Must provide a configurable that identifies potential incidents of fraud, waste, abuse and erroneous payments. IV.N.5 Operations Phase - Business Architecture Overview - Program Integrity Must develop, update and maintain an algorithm library throughout the life of the contract. New algorithms will be created by SState staff, the Contractor, and the program integrity field as the industry changes and as the nature of fraud, waste abuse, and erroneous payments evolves. IV.N.5 Operations - Business Architecture Overview - Program Integrity Must authorized users to create, modify, and run the rules and algorithms with limited or no technical support. IV.N.5 Operations Phase - Business Architecture Overview - Program Integrity Must incorporate link analysis of providers and members where relationships extend beyond provider to provider relationships (e.g. interwoven relationships between providers, members,
Revised%20Attachment%20B%20-%20Business%20and%20Technical%20Requirements%20Matrix.docx