Thomas Kennett Email and Phone Number

CCIIO-ER&R EDI Analyst The Center for Consumer Information and Insurance Oversight (CCIIO) of CMS Enrollment Resolution and Reconciliation (ER&R) - Incumbent’s role is to provide:• Support to ensure individuals are successfully enrolled on a timely basis• Proper accounting to the Centers for Medicare & Medicaid Services (CMS), the States, and QHPs• Individuals, taxpayers, and policymakers with proper accounting through CMS, the States, and Quality Health Plans (QHP)• Assistance to the entire community of stakeholders to improve enrollment processes and systemsTwo primary tasks:• Fix enrollments that break• Address discrepancies in reconciliations of enrollmentsHIPAA compliancy training completed for 2015 and 2016.

Technical BA position to provide advisory services to assist the State Project Director, and PMO with their technical understanding of the project regarding system architecture, hardware, software, telecommunication, network configuration, and testing issues. • Cognosante Lead analyst for interface capture quality assessment project• Member of team to establish interface criteria and standards for secure communication of data within and outside the enterprise• Establish and maintain tight controls over technical requirements• Attend and document Requirements Validation sessions• Provide Claims and Financial technical analysis and expertise • Business lead for EDI Requirements Validation (RV) Sessions• Lead analyst for interface capture quality assessment

This BA position entailed providing Claims expertise for testing COBOL programs renovated for processing ICD10 Diagnosis and Procedure Codes. Analyze and document SC MMIS Claims business rules, edit rules, audit rules, to create and process unit and string test cases to verify and validate updated programs. Also entered test cases to validate ICD10 data capture screens. Wrote file compare routines to ensure on-going changes in legacy were correctly applied to renovated programs.

This EDI BA consultant position entailed providing subject matter expertise in Medicaid for the HIPAA mandated EDI 4010A1 to 5010 conversion. Validated EDI mapping and documentation and companion guides for correct formats and values.Reviewed CAQH/Core Rules Analysis for Phase I and II. Analyzed and documented EDI business rules, policies and procedures for gap analysis and mapping changes for vendor development. Member of State MITA 2.0 “As Is’ Assessment Team. HIPAA compliancy training completed for 2012.

This MMIS system technical team lead position encompassed the transition of a legacy MMIS application using VSAM files to ACS OmniCaid application based on DB2 with a Web Portal interface. Provided guidance and mentoring to a team tasked with implementing the MMIS upgrade. Additionally, provided DB2 programming support and analysis for the Provider subsystem.