Notice ID CMS-A240106
To enhance access to CMS data related to beneficiary payment and utilization, encounter, and enrollment data, OEDA has identified a need for contractor assistance in relation to developing, modifying, and disseminating OEDA’s many Public Use Files (PUFs), advanced analytics projects, internal databases, as well as other ad-hoc data analysis requests.
At a minimum, the following knowledge and experience with the U.S. Department of Health and Human Services (HHS)/CMS or equivalent is required:
- Proficiency with Medicare Parts A, B, and D, administrative, claims, assessment, and/ or financial data in the CMS environment or similar health insurance environment;
- Proficiency with Medicare Advantage encounter data;
- Proficiency with Medicaid claims data;
- Proficiency with CMS enrollment data;
- Proficiency with Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) and proficiency in understanding of Medicare Part B payment systems (e.g., Outpatient billing and Physician and Other Practitioner fee schedules);
- Proficiency working with and safeguarding PHI and PII;
- Proficiency providing all stages of data analytics (data acquisition, validation, analysis, algorithms, adjusting for outliers, etc.) under tight timeframes;
- Proficiency researching, reviewing, and interpreting CMS policy (e.g., Final Rule for Medicare Skilled Nursing Facilities) and applying this knowledge to the data that is analyzed;
- Proficiency in conducting and applying suppression to deliverables;
- Proficiency using complex data sets of at least 1,000,000,000 lines of data and merging data from multiple sources;
- Proficiency maintaining, expanding, and developing analytic databases;
- Proficiency with various software/language/data environments such as Statistical Analysis System (SAS), Excel, Databricks, Apache Spark, Tableau, R Studio, Snowflake, ArcGIS, Python, Structured Query Language (SQL), GitHub, Amazon Web Services (AWS) reporting and visualization tools…
