Connecticut Medicaid Enterprise Technology System Program

(CT METS)

Key Contractor Roles & Responsibilities

Independent Verification and Validation (IV&V) contractor

The IV&V Scope of Work includes the contractor’s independent and unbiased reporting and evaluation for project progress to the Centers for Medicare and Medicaid Services (CMS). The IV&V contractor is a third-party entity providing unbiased oversight. The contractor monitors and makes recommendations that support overall quality assurance to the program.

Organizational Change Management (OCM) contractor

The OCM contractor will work closely with DSS business areas to obtain feedback about current processes used for Medicaid business functions. At the end of Phase 1, the OCM contractor will have gathered enough information to deliver recommendations for changes that would align business functions with information systems to provide improved efficiencies and healthcare outcomes for members.

System Integrator (SI) contractor

The SI contractor will work together with the OCM contractor to assess and recommend technology systems. The SI contractor will help lead the design, development, and implementation of a new modular-technology Medicaid enterprise that manages the information and information systems shared by all who interact with Medicaid. DSS Medicaid business functions and processes will be packaged into technology called modules that help support the entire Medicaid enterprise, from members accessing their health information, to providers coordinating and referring care, and payors ensuring payment of Medicaid claims. Note: The Systems Integrator (SI) RFP is "Closed" and the status of the RFP will remain "Under Evaluation" until a successful contract is established.