122125 O3 Alivia Analytics Technical Narrative Response Proprietary File 1 of 4.pdf

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Program Integrity Case Management (PICM) and Fraud Abuse Detection (FAD) Analytics Solution
Solicitation number
122125 O3
Issued by
Blaine County, Nebraska

About this file

This document is a comprehensive technical proposal from Alivia Analytics in response to the Nebraska Department of Health and Human Services (DHHS) Request for Proposal (RFP #122125) for a Program Integrity Case Management (PICM) and Fraud Abuse Detection (FAD) Analytics Solution. The proposal details Alivia's approach to implementing a cloud-based Software as a Service (SaaS) platform designed to support Medicaid program integrity efforts, with a focus on fraud detection, case management, and analytics for approximately 340,000 Medicaid recipients. The proposal was submitted on July 10, 2025, with an expected implementation date no later than October 31, 2026. The contract term is initially five years, with options to renew for two additional two-year periods, and includes provisions for system configuration, data migration, training, and ongoing maintenance and support.

The proposed solution is funded through enhanced federal financial participation (FFP) and will require CMS certification, with Alivia committed to supporting the entire certification process. The system must integrate with existing state systems, including the Medicaid Management Information System (MMIS) and Nebraska Family Online Client User System (N-FOCUS), and comply with strict security requirements including TLS encryption, AES-256 data protection, and HIPAA compliance. The state will allocate up to 500 vendor hours annually for system modifications at no additional cost. Alivia's solution leverages AI-assisted analytics, advanced ETL processing, and a scalable case management platform designed to handle large volumes of complex cases while supporting batch processing of audits and educational letters.

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122125 O3 Deloitte File 9 of 9 Attachment 3 Technical Specifications (Redacted).pdf PDF
Addendum 1 - Attachment 2 - Functional Specifications [Use This Attachment].docx DOCX document
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122125 O3 Attachment 4 - Data Integration Guidelines.docx.pdf PDF
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Statement of Proprietary Information_Deloitte - 122125.docx DOCX document
122125 O3 Alivia Analytics Technical Narrative Response Proprietary File 1 of 4.pdf PDF
122125 O3 Attachment 6 - Deviations Form to Section VI.docx.docx DOCX document
122125 O3 Deloitte File 5 of 9 Cost Sheet.pdf PDF
Addendum 2 - Question & Answers.pdf PDF
122125 O3 Attachment 6 - Deviations Form to Section VI.docx.docx DOCX document
122125 O3 PICM RFP Solicitation Evaluation Criteria.docx.pdf PDF
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122125 O3 Attachment 4 - Data Integration Guidelines.docx.pdf PDF
Addendum 2 - Question & Answers.pdf PDF
Solicitation List of Respondents.pdf PDF
122125 O3 Attachment 1 - Minimum Qualifications.docx.docx DOCX document
122125 O3 Attachment 4 - Data Integration Guidelines.docx.pdf PDF
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July 10, 2025 Copyright © Alivia Analytics™. All rights reserved.

Unauthorized copy or use of this document is prohibited

RESPONSE TO NEBRASKA RFP

#122125

PROGRAM INTEGRITY CASE

MANAGEMENT (PICM) /

FRAUD ABUSE DETECTION (FAD)

ANALYTICS SOLUTION

Alivia Analytics

16 Campus Blvd Suite 125, Newtown Square, PA 19073

Phone: +1-617-227-5112

E-mail: info@aliviaanalytics.com

Web: https://www.aliviaanalytics.com

© 2025 Alivia Analytics mailto:info@aliviaanalytics.com https://www.aliviaanalytics.com/

Table of Contents

EXECUTIVE SUMMARY

1 CORPORATE OVERVIEW

a. Bidder identification and information

b. Financial statements

c. Change of ownership

d. Office Location

e. Relationships with the State

f. Bidder's employee Relations to the State

g. Contract Performance

h. Summary of bidder’s corporate Experience

i. Bidder’s proposed Personnel Management Approach

j. Subcontractors

2 TECHNICAL RESPONSE

a. Understanding of the project requirements;

b. Proposed development approach;

c. Technical considerations;

d. Project work plan, management, and implementation; and

e. Deliverables and due dates

3 APPENDIX

a. Contractual Agreement Form (separately attached)

b. Terms and conditions

c. Vendor Duties

d. Payment

e. Completed Attachment 1 – Minimum Qualifications

f. Responses to sections II through IV*

g. Additional Documents

3.1 Terms and Conditions

3.2 Vendor Duties

3.3 Payment

Response to Nebraska RFP #122125 Program Integrity Case Mgmt (PCIM) / Fraud Abuse Detection (FAD) Analytics Solution

July 10th, 2025 Copyright © Alivia Analytics™. All rights reserved.

EXECUTIVE SUMMARY

Executive Summary

Alivia Analytics (Alivia) began dedicated work in the healthcare space in 2016 with a clear mission: to bring clarity, accountability, and innovation to healthcare program integrity. Over the past decade, we’ve grown into a trusted partner for seven (7) state governments with two (2) more under contract review and several national healthcare organizations. Our experience has grown but we’ve never lost the mindset that got us here, one that blends deep experience with a constant drive to improve, evolve, and deliver more value.

We’re proud to say this isn’t our first time doing this work, but we also know that doing it well means never doing it the same way twice. Every state Medicaid agency is different. Every program has its own nuances, regulations, and business processes. And every implementation is an opportunity to bring fresh thinking, new tools, lessons learned, and better outcomes to the table. That’s where Alivia thrives in the sweet spot between proven experience and continuous innovation.

A Partner That’s Been There and Still Thinks Like a Challenger

Alivia sits in a unique position in the market. We’ve delivered successful implementations in Missouri, Utah, and with Lumeris, each with measurable outcomes and long-term client satisfaction. In Missouri, our FWA Finder™ platform helped generate a 12:1 return on investment in recoveries and a 50:1 return when including savings and prevented loss. In Utah, we led a full CMS-aligned implementation of our Case Manager™ and analytics platform, tailored to the state’s operational and compliance needs. And with Lumeris, we’ve supported internal monitoring and compliance across their provider network, adapting our tools to fit their unique delivery model.

But we’re not a legacy vendor. We’re agile, responsive, and constantly innovating. Our platform is built on modern, cloud-native architecture. Our fraud detection models are powered by AI and machine learning along with immense subject matter expertise. Our team includes former Medicaid Program Integrity directors, CMS certification experts, program integrity veterans, and data scientists who know how to turn complex data into actionable insights.

What It’s Like to Work with Alivia

Clients often tell us that working with Alivia feels different. That’s by design. We believe that great technology is only half the equation with the other half being the people. We bring a team that listens first, then configures and delivers. We communicate clearly, manage risk proactively, and stay engaged long after go-live. Our project management approach is grounded in the Project

Management Body of Knowledge (PMBOK®) framework, ensuring structure, accountability, and transparency throughout the lifecycle.

We also bring a customer success mindset. That means regularly scheduled status calls, bi-weekly post-go-live support, and a culture of responsiveness that’s baked into everything we do.

Our goal isn’t just to deliver a system—it’s to deliver confidence, clarity, and results.

What You’ll Find in This Document

This response to Nebraska’s RFP #122125 outlines our proposed solution for a Program Integrity Case Management (PICM) and Fraud, Abuse, and Detection (FAD) Analytics System. It includes:

• Corporate Overview: A snapshot of Alivia’s history, financial strength, and client base, including references from Missouri, Utah, and Lumeris.

• Technical Response: A detailed explanation of our platform architecture, fraud detection models, case management workflows, and how we support CMS certification.

• Project Management Plan: A structured, PMBOK®-aligned approach to planning, execution, risk management, and communication.

• Implementation Timeline: A clear roadmap from kickoff to go-live, including milestones for UAT, training, and warranty support.

• Training and Support Strategy: A role-based training program, online documentation, and ongoing support to ensure long-term adoption and success.

• CMS Certification Support: A comprehensive plan for guiding the State through Operational Readiness Reviews, Certification Reviews, and all required documentation and evidence.

• Post-Implementation and Maintenance: A roadmap for long-term operations, including help desk support, system upgrades, and enhancement planning.

Throughout the document, you’ll see that we approach this work with rigor and a belief that technology should serve people, not the other way around. We’re excited about the opportunity to bring that approach to Nebraska, and to help the State build a system that’s not only compliant and efficient, but genuinely transformative.

1 CORPORATE OVERVIEW

A. BIDDER IDENTIFICATION AND INFORMATION

Full company name Alivia Analytics, LLC

Company’s address 16 Campus Blvd, Suite 125. Newtown Square, PA 19073

Entity organization Corporation

State of incorporation Delaware

Year organized 2011

Any name changes Alivia Analytics, Inc

Alivia Capital

B. FINANCIAL STATEMENTS

As a privately held company, Alivia Analytics, LLC does not disclose financial information. However, we have the capacity to support Nebraska. We recognize that working with a financially stable company is essential to the success of the project, and we will be here to help you for the long term. This commitment is substantiated and recognized across other states with now having eight (8) state government clients adopting Alivia Analytics as their analytics and case management solution as of July 2025.

Our financial outlook is very strong both currently and in the future. Our future book of business is very exciting, and the market adoption of our product and services continues to exceed our internal planning expectations.

In addition to our strong financial position, Alivia is backed by two prominent healthcare private equity firms: Council Capital and Health Enterprise Partners. Beyond strong financial backing, these partnerships also provide Alivia with continuous access to “best practices” and innovations in advanced analytics. We are happy to facilitate a call with our partners to discuss any financial questions that you may have. Also, we are happy to facilitate a call with our banker, Alexander Hui, at JPMorgan.

These private equity firms have heavily invested in our development. With their backing, we have made significant investments in cloud hosting, AI development, and security expansions to include HITRUST certification. Their commitment and financial dedication continue to focus on growth in our suite of solutions and services to our clients.

Alivia’s business plan is to continue our dedicated focus on providing best-in-class solutions to the market. We are proud of the quality of products we provide to our customers, and our customer references speak to this commitment.

Alivia has also supplied as an attachment our Duns & Bradstreet credit report, which has a strong outlook and exhibits very low risk for our clients. In addition, the following is our DUNS number, so you are able to review our latest D&B information:

Pending Suits

None

Open Tax Liens

None

Unsatisfied Judgements

None

Score Tracker

DUNS Company Name Delinquency Score

Failure Score Paydex Rating

11-898-6675 Alivia Analytics, LLC 91 73 80 1R3

C. CHANGE OF OWNERSHIP

No change in ownership or control of the company is anticipated during the twelve (12) months following the solicitation response due date.

D. OFFICE LOCATION

Alivia’s headquartered at 16 Campus Blvd, Suite 125 Newtown Square, PA19073. This office along with many remote/virtual employees will be responsible for performance.

E. RELATIONSHIPS WITH THE STATE

Alivia has not had any dealings with the state over the past five (5) years.

F. BIDDER'S EMPLOYEE RELATIONS TO THE STATE

No party named in the bid or employee had such relationships with the State.

G. CONTRACT PERFORMANCE

Alivia is proud to state we have never had a contract terminated for default, convenience, non-performance, non-allocation of funds. The only contract that has ever been terminated was due to a commercial health plan being acquired and the purchasing entity had an in house FWA solution that was required to be leveraged.

H. SUMMARY OF BIDDER’S CORPORATE EXPERIENCE

REFERENCE CASE #1

i. Description

a) Time period of project

a. Project implementation began in April 2021, with go-live in January 2022. Enhancements and data integrations continued through 2024, and the contract has been extended for an additional 5 years through 2029.

b) Scheduled and actual completion dates

a. Scheduled Completion: January 2022

b. Actual Completion: December 2021 (Go-Live)

c. Enhancements: Continued through 2024, including EVV and MCO data integrations

c) Bidder’s responsibilities Alivia Analytics was responsible for delivering the FWA Finder™ platform to support Missouri’s Medicaid Program Integrity efforts. Responsibilities included:

• Implementing FWA Finder™ to detect and prioritize leads across MMIS FFS and MCO data

• Integrating historical and current Medicaid data (2016–2021), including EVV data from Sandata

• Supporting CMS certification efforts, including documentation and IAPD development

• Delivering high-value analytics that contributed to an estimated 12:1 return on investment on recoveries and 50:1 including savings and prevented loss

• Providing ongoing support and enhancements under a multi-year contract

Note: Missouri had an existing case management system in place at the time of implementation. While Alivia did not provide case management functionality, the State has expressed interest in adopting Alivia’s case management module in the future to unify analytics and investigative workflows.

d) Customer information Agency: Missouri Department of Social Services – Missouri Medicaid Audit & Compliance (MMAC)

Contact Person: Darla Weekley, Program Integrity Lead

Phone: 573-751-5296

Email: Darla.Weekley@dss.mo.gov

Address: P.O. Box 6500, Jefferson City, MO 65102

e) Prime or Subcontractor Although Alivia is technically listed as a subcontractor, that is only due to the procurement path of using the NASPO Cloud Solutions contract and Alivia did all of the work and worked directly with the customer as a prime vendor. SHI’s only role was to be a contracting intermediary and had no role in the implementation.

• Procurement Path: Purchase Order issued to SHI, with Alivia as the subcontracted vendor

• Timeline: Implementation completed in 8 months

• Contract Status: Extended through 2029 based on performance and stakeholder satisfaction

ii. Bidder and Subcontractor experience

Alivia did not leverage a subcontractor for this project.

iii. Work Performed as Subcontractor

REFERENCE CASE #2

mailto:Darla.Weekley@dss.mo.gov

a) Time period of project

Alivia kicked off this implementation in November 2023 and Go Live was August 2024.

b) Scheduled and actual completion dates

a. Goal was 7 Month implementation

b. 9 Month implementation due to delays in getting data and holiday conflicts right at kickoff.

c) Bidder’s responsibilities As the prime vendor for the Utah Office of Inspector General (UOIG) Case Management System and Fraud Detection Tool implementation, Alivia Analytics was responsible for the full lifecycle of the project, from planning and design through implementation and support.

Alivia led the system architecture and design efforts, producing the System Design Document and Configuration Management Plan that defined the technical architecture, data flows, and configuration protocols for the UOIG Case Manager™ platform. These deliverables were key to aligning the system with Utah’s operational needs and CMS expectations.

The team also managed CMS certification alignment and APD compliance. This included drafting the CMS Intake Form and mapping Utah’s APD-approved metrics to CMS’s Program Integrity module certification framework. The project was governed by an Implementation Advance Planning Document (I-APD), which emphasized interoperability with CHIP and other human services programs.

A major component of Alivia’s work involved configuring the case workflow engine to reflect UOIG’s operational procedures. This included building a detailed status stage transition model from “New Lead” through “Final Overpayment Recovered” and integrating User Defined Fields (UDFs) across all major modules to support flexible data capture and reporting.

Security and continuity were also prioritized. Alivia delivered updated Information Security and Business Continuity Plans to ensure compliance with both state and federal standards.

Throughout the project, Alivia maintained a strong focus on stakeholder engagement. The team held monthly customer success meetings and worked closely with UOIG leadership, including Gene Cottrell and Nathan Johansen, to ensure alignment and transparency.

During the user acceptance testing (UAT) and production phases, Alivia supported change request reviews and facilitated UAT in partnership with UOIG testers, ensuring that the system met user expectations and operational requirements.

d) Customer information Customer Name: Utah Office of Inspector General of Medicaid Services

Contact Person: Gene D. Cottrell, Inspector General

Email: gcottrell@utah.gov

Phone: 801-599-4372

e) Prime or Subcontractor Although Alivia is technically listed as a subcontractor, that is only due to the procurement path of using the NASPO Cloud Solutions contract and Alivia did all of the work and worked directly with the customer as a prime vendor. SHI’s only role was to be a contracting intermediary and had no role in the implementation.

• Procurement Path: Purchase Order issued to SHI, with Alivia as the subcontracted vendor

• Timeline: Implementation completed in 8 months

• Contract Status: Extended through 2029 based on performance and stakeholder satisfaction mailto:gcottrell@utah.gov

REFERENCE CASE #3

Time Period of Project The project began in March 2022, following the execution of a three-year agreement.

Lumeris has since renewed for the additional two-year extension, and the engagement remains active as of 2025.

Scheduled and Actual Completion Dates Initial deployment milestones were completed on schedule in 2022. The platform has continued to evolve through 2023 and 2024, with ongoing enhancements and support continuing into the current renewal term.

Bidder’s Responsibilities Alivia served as the prime vendor and was responsible for the full deployment of its FWA Finder analytics engine and integrated Case Manager platform. The solution was designed to help Lumeris identify at-risk claims, streamline investigations, and strengthen program integrity.

Key responsibilities included:

• Implementing business dashboards that surfaced outlier providers and suspicious claims in real time.

• Supporting both technical and non-technical users with flexible tools, ranging from drag-and-drop interfaces to advanced scripting in R and Python.

• Leading enablement efforts through training, documentation, and collaborative working sessions with stakeholders across compliance, clinical operations, claims strategy, and network management.

• Adapting the platform to support internal monitoring for Clear Practice programs like Primarily Home and Healthy House Calls, where Lumeris acts as the provider and needed visibility into its own billing patterns.

• Maintaining a strong partnership with Lumeris leadership, including onboarding sessions with their Chief Medical Officer and regular collaboration with Integrity Advantage, their risk assessment partner.

• Customer Information Customer: Lumeris Contact: Julie Nichols

Phone: 314-825-3009

Email: jnichols@lumeris.com

Prime or Subcontractor Alivia Analytics acted as the prime vendor.

I. BIDDER’S PROPOSED PERSONNEL MANAGEMENT

APPROACH

Proposed Project Management Approach

Alivia presents a project management approach that is both structured and adaptive, grounded in industry best practices and tailored to the complex demands of healthcare analytics implementations. Their methodology is rooted in the Project Management Body of Knowledge (PMBOK®) framework, emphasizing clarity, accountability, and efficiency throughout the project lifecycle.

At the heart of Alivia’s approach is a commitment to clear communication and meticulous planning. They prioritize early alignment with stakeholders through detailed project planning, which includes defining scope, setting milestones, allocating resources, and establishing timelines. This planning phase is followed by regular status updates, typically weekly or biweekly, where key performance indicators, deliverables, and risks are reviewed collaboratively with the client.

Alivia employs a suite of project management tools such as Microsoft Project and JIRA to maintain a centralized view of progress. These tools support real-time tracking of tasks and deliverables, enabling the team to respond quickly to emerging issues.

Their issue escalation process is well-defined, ensuring that problems are promptly identified, assessed, and resolved.

The project lifecycle is divided into eight distinct phases: Start- Up/Planning/Transition, Requirements, Design and Build/Configuration/Conversion, Testing, Training, Deployment/Implementation/Certification, Operations, and Project Turnover. This phased approach allows for structured progression while maintaining flexibility to adapt to client-specific needs.

Risk management is another cornerstone of Alivia’s methodology. Their strategy includes identifying potential risks early, developing mitigation and contingency plans, and continuously monitoring risk status. This proactive stance is complemented by a robust quality management plan that ensures deliverables meet or exceed expectations through peer reviews, checklists, and adherence to defined standards.

In summary, Alivia’s project management philosophy is a blend of rigor and responsiveness. By combining PMBOK® principles with agile practices and a deep understanding of healthcare program integrity, they position themselves as a reliable partner capable of delivering high-quality, timely, and impactful solutions.

Staffing Support Alivia has crafted a staffing plan that best meets the needs of the requirements in the RFP. Alivia’s proposed Contract Manager, Dale Carr has significant experience within their respective role. Dale is a former Medicaid Program Integrity director and familiar with the challenges that state Medicaid agencies face. He brings a perspective and level of subject matter expertise that only select few have in the private sector. Dale will provide a day to day contact for the program integrity side of the house and supported by the Alivia leadership and support team.

In addition to the required Contract Manager role that Dale will provide. Alivia as a suite of staff that are typical for an implementation, the following additional Alivia roles are involved: Executive Sponsor, Business Analyst, Data Engineers Data Scientist, System Administrator, Security Officer, Developers, and Subject Matter Experts. Alivia works with customers to provide a high-quality experience both through and post-implementation.

Our data scientists and the data engineering team are led by the Chief Analytics Officer Matt Perryman. The data science team is responsible for model ideation and configuring the models to account for Nebraska specific nuances. From our project management team, we've initially assigned Cassondra O'Brien to serve as the implementation Project Manager. Cassandra has decades of experience serving as a project manager both on the technical and business sides of projects. She has successfully led other Alivia deployments including those that have CMS certification components.

One of our subject matter experts like Dale, is Michael Boutte. Michael is also a former Medicaid employee, where he last served in Louisiana as the Deputy Medicaid Director. Michael oversees our compliance department as well as our payment integrity team and overseen multiple successful CMS Certification projects on behalf of Alivia.

Alivia has included resumes for the named individuals as attachments.

Exhibit 1: Alivia’s High Level Org Chart

J. SUBCONTRACTORS

Alivia does not intend to use Subcontractors on this project.

2 TECHNICAL RESPONSE

PART I

A. UNDERSTANDING OF THE PROJECT REQUIREMENTS;

i. Scope of Work Alivia proposes a robust, scalable, and cloud-based Software as a Service (SaaS) solution, our platform which includes the FWA Finder™ and Case Manager™ modules. This platform is designed to support the full lifecycle of fraud, waste, and abuse (FWA) detection, investigation, and resolution. It is built to integrate seamlessly with state systems and meet the operational needs of diverse stakeholders, including program administrators, investigators, analysts, referral intake specialist, and external partners.

The FWA Finder™ module delivers over 100 pre-configured fraud detection models that leverage both rule-based logic and advanced machine learning techniques, including supervised and unsupervised algorithms. These models are capable of identifying improper payments across medical, pharmacy, and dental claims, and are continuously updated to reflect emerging fraud schemes and regulatory changes. Each model is paired with interactive dashboards that allow users to drill down into provider behavior, risk scores, and claim-level details, enabling precise targeting of high-risk entities. Alivia is also one of the first to deploy a solution that address that unique and diverse EVV, successfully yielding results for the state of Missouri.

Complementing this is the Case Manager™ module, which is fully integrated with FWA Finder™. It supports configurable workflows, automated alerts, and comprehensive case tracking from referral through investigation, adjudication, and recovery. This integration eliminates manual data entry, enhances efficiency, and ensures that all investigative actions are documented and auditable.

Alivia’s platform is designed to be compliant with HIPAA, HITECH, and CMS standards. The company has a proven track record of supporting CMS certification efforts, having successfully guided multiple state clients, including the Utah Office of Inspector General, Missouri Medicaid Audit and Compliance, and Wyoming Department of Health through Operational Readiness Reviews and certification processes. Alivia’s experience with CMS certification ensures that the proposed solution will meet the State of Nebraska’s goal of securing enhanced federal funding.

In terms of implementation, Alivia commits to all tasks required to render the system fully operational. This includes the conversion, transformation, formatting, and migration of ten years of historical case data. Our experienced data ingestion team applies best practices in data cleansing, validation, de-duplication, normalization, and enrichment to ensure data integrity and readiness for analytics.

Alivia’s approach is grounded in agile development methodologies, allowing for rapid deployment, iterative improvements, and responsiveness to stakeholder feedback. Our team includes seasoned professionals with deep expertise in Medicaid program integrity, healthcare analytics, and enterprise system integration.

In summary, Alivia offers a state-of-the-art, end-to-end solution that not only meets but exceeds the State of Nebraska’s requirements for a PICM / FADS Analytics system. Our platform is designed to enhance decision-making, increase operational efficiency, and deliver measurable outcomes in the fight against healthcare fraud, waste, and abuse.

Alivia has accounted for the potential of additional/other services to be performed as a part of the scope of work during the Maintenance, Operations, and Support period. We have accounted for the 500 vendor hours annually and are prepared to review and scope request that are submitted by the State.

ii. Project Environment

a) Integration Requirements Alivia’s platform is a modular, cloud-based architectural framework grounded in its proven architecture and integration capabilities. This architecture is designed to minimize dependence on traditional IT infrastructure while maximizing scalability, flexibility, and security. The platform is modular by design, allowing for the addition of new components and services without requiring pervasive changes to existing systems, a feature that we take advantage of regularly when planning our enterprise wide roadmap.

To meet Nebraska’s integration needs, Alivia’s solution supports secure, bi-directional data exchange with both internal and external systems, including legacy platforms such as MMIS and N-FOCUS. We have reviewed the data integration requirements and are confident that we can support the State’s data integration needs.

Alivia explicitly supports Extract, Transform, and Load (ETL) functions, enabling efficient data migration, transformation, and formatting. These capabilities are essential for onboarding historical data and maintaining ongoing interoperability with the State’s data warehouse and other modules. Alivia also commits to working with the State’s Integration Hub to orchestrate inbound and outbound interfaces and establish appropriate connectivity.

iii. Compliance Requirements Alivia commits to meeting the Compliance Requirements as listed within the proposal. This includes the Seven Standards and Conditions, set forth by CMS and MITA standards to maintina and receive enhanced federal financial aparticipation

(FFP). Alivia also commits to maintaining compliance with all State, fedederal, CMS standards, regulations, and compliance guidances.

iv. Project Requirements

a) Functional Specifications Alivia has reviewed in detail Attachment 2 – Functional Specifications and completed per the instructions within the attachment. The completed Attachment 2 – Functional Specifications is included in our submission.

b) Technical Specifications

Alivia has reviewed in detail Attachment 3 – Technical Specifications and completed per the instructions within the attachment. The completed Attachment 3 – Technical Specifications is included in our submission.

c) Executive Kick off Alivia would approach the executive leadership project kickoff with a structured, collaborative, and transparent methodology that reflects our deep understanding of the project’s scope and our commitment to successful delivery.

Alivia prides itself in having a successful kickoff meeting that aligns stakeholders at the very onset of the project. During the kickoff meeting Alivia will focus on the “spirit of the requirements” which focuses on a requirements outcome alignment. Ensuring that the State’s objectives/outcomes for each requirement are met. This approach has proven successful for each of our state Medicaid clients.

Alivia will plan and conduct a comprehensive executive leadership kickoff meeting that includes our assigned leadership team, project management staff, and key technical and operational personnel.

i. Pre-Kick off

As part of our project initiation process, Alivia will develop and deliver a comprehensive executive kickoff presentation that will be submitted to the State for review and approval at least five (5) business days prior to the scheduled kickoff meeting. This presentation will serve as a foundational deliverable and will include the following key components: Overview of Alivia’s Approach, methodology, and timelines for completing the PICM project. Which includes best practices and lessons learned from other PICM like projects deployed for our state Medicaid clients.

ii. Kick off Alivia will organize and lead an onsite kickoff within two (2) weeks of contract execution. The event will include key representatives and subject matter experts essential for the start of the project. The kickoff presentation will cover an overview of the project scope, requirements, project schedule, team matrix, and a summary of how critical tasks will be accomplished to achieve implementation.

A requirements review exercise, referred to as the “spirit of the requirements,” will be conducted to confirm that high-level requirements align with the intended outcomes expected by the State. It is common for the intent of requirement outcomes to differ from what was originally documented, particularly when changes occur between the time requirements are written and project initiation. This process helps ensure alignment at the beginning of the project rather than later during implementation.

Throughout the kickoff, Alivia aims to facilitate discussions among stakeholders, allowing for feedback and clarification of expectations. This is critical for all parties to level-set and ensure successful achieve of the State’s operational, timeline and budget expectations.

iii. Post Executive Kick off Alivia will provide the state with detailed meeting minutes of the Kick off within two

(2) business days following the kickoff.

d) Project Initiation and Planning

i. Develop a Detailed Project Plan Alivia Analytics is committed to delivering a structured, transparent, and collaborative project management approach that aligns with the State’s expectations for a Master Project Plan and Integrated Master Project Schedule. Within three weeks of project kickoff, Alivia will prepare and submit a comprehensive Master Project Plan for the State’s review and approval. This plan will serve as the foundational blueprint for the entire project lifecycle and will be developed in close coordination with the State’s stakeholders to ensure alignment with project goals, timelines, and compliance

Alivia will develop a Master Project Schedule using Microsoft Project, as required.

This schedule will:

• Identify all activities and tasks necessary to implement the PICM Project.

• Include a detailed Work Breakdown Structure (WBS).

• Clearly delineate responsibilities between the State and Alivia.

• Map all dependencies, sub-tasks, successors, and predecessors.

• Specify start and end dates for each task and activity.

• Estimate hours for each task and sub-task, including those on the critical path that could impact the overall timeline

Alivia’s project management methodology is grounded in Agile principles and supported by tools such as Microsoft Project and JIRA. Weekly status meetings during implementation will ensure continuous communication, risk mitigation, and alignment with the State’s evolving needs. Any changes to the Master Project Plan or Schedule after initial approval will be submitted for review and electronic signature by the designated State stakeholder, ensuring full transparency and traceability

Throughout the project, Alivia will maintain and update both the Master Project Plan and Integrated Master Project Schedule to reflect progress, address risks, and incorporate feedback. This disciplined yet flexible approach ensures that the project remains on track, meets its objectives, and delivers measurable value to the State.

ii. Develop a Project Mangement Plan Alivia’s approach to the Project Management Plan (PMP) is to provide the State with a comprehensive, actionable, and living document that guides the project from kickoff through completion. Within three weeks of project kickoff, Alivia will deliver a detailed PMP for State review and approval. This plan will be maintained and updated throughout the project lifecycle, and any changes after initial approval will be submitted for review and approval by the designated State stakeholder(s).

The PMP will begin with an executive summary that outlines the project’s objectives, scope, major milestones, and overall approach. For risk and issue management, Alivia will use a proactive process to identify, assess, track, and mitigate risks and issues, maintaining a risk register and escalating as needed for timely resolution.

Communication management will be addressed through a clear plan that defines how, when, and with whom project information will be shared, including regular status meetings, executive summaries, and a centralized document repository.

Staffing management will detail the project’s organizational structure, key personnel, roles, and responsibilities for both Alivia and State teams. Change management procedures will be established for requesting, reviewing, approving, and documenting changes to project scope, schedule, or deliverables, with all changes requiring review and approval by the designated State stakeholder(s).

Quality management will define standards, processes, and checkpoints for ensuring the quality of all project deliverables, including peer reviews and quality assurance testing.

Deliverable management will use a structured process for planning, tracking, reviewing, and accepting all project deliverables, with defined acceptance criteria, timelines, and responsible parties. Scope management will clearly define the project’s boundaries, deliverables, and success criteria, and include processes for managing scope changes.

Schedule management will be addressed through a detailed project schedule, maintained in Microsoft Project, that includes all tasks, dependencies, milestones, and critical path activities, with regular updates and progress tracking. Budget management will outline processes for tracking project expenditures, managing financial resources, and reporting on budget status, with regular updates and collaboration with the State to ensure fiscal responsibility. Finally, performance management will define and monitor key performance indicators, project milestones, and success metrics, with regular reviews and lessons learned sessions to drive continuous improvement and ensure the project delivers its intended value.

In summary, Alivia’s PMP will be a living document that covers all required areas, risk, communication, staffing, change, quality, deliverables, scope, schedule, budget, and performance, ensuring the State has full visibility and control throughout the project.

iii. Develop a Risk Management Plan Alivia’s approach to risk management is to provide the State with a comprehensive Risk Management Plan within three weeks of project kickoff. This plan will be developed in collaboration with State stakeholders and will be maintained and updated throughout the project lifecycle. If any changes are made after initial approval, the revised plan will be submitted for review and approval by the designated State stakeholder(s).

The Risk Management Plan will identify, evaluate, and plan for possible risks that could arise during the project. Alivia will use a proactive process to systematically identify potential risks early, assess their likelihood and potential impact, and document them in a risk register. For each risk, we will define mitigation and contingency strategies in advance, so that risk-handling activities are prepared and adverse impacts on project objectives are minimized.

Throughout the project, risks and issues will be reviewed regularly in project status meetings and included in status reports. If new risks emerge or existing risks change, the plan will be updated accordingly, and the State will be engaged to review and agree on any new mitigation strategies. This disciplined approach ensures that risk management is not a one-time activity, but an ongoing process that supports project success and transparency at every stage.

iv. Develop an Issue Management Plan Alivia will provide the State with a detailed and comprehensive Issue Management Plan within three weeks of project kickoff. This plan will be developed in collaboration with State stakeholders and will be maintained and updated throughout the project lifecycle. If any changes are made after initial approval, the revised plan will be submitted for review and approval by the designated State stakeholder(s).

The Issue Management Plan will outline a clear process for identifying, tracking, and resolving issues that arise during the project. When an issue is identified, whether by Alivia, the State, or another stakeholder, it will be documented in an issue log with a description, origin, date, and initial assessment. Each issue will be evaluated for its potential impact and urgency and prioritized accordingly.

The plan will describe how issues are tracked from identification through resolution, including regular status updates, assignment of responsible parties, and escalation procedures for issues that cannot be resolved at the project team level. Communication protocols will ensure that all relevant stakeholders are informed of significant issues and their status. Alivia will provide regular reporting on open, resolved, and escalated issues as part of project status updates.

Roles and responsibilities for issue management will be clearly defined. Typically, the Project Manager will oversee the issue management process, ensure issues are logged and tracked, and coordinate with both Alivia and State team members for resolution.

Specific team members may be assigned to investigate and resolve particular issues, and escalation paths will be established for issues requiring higher-level attention.

To support consistent evaluation and prioritization, Alivia will use an impact matrix that categorizes issues based on their severity (e.g., critical, high, medium, low) and their potential effect on project scope, schedule, cost, or quality. This matrix will guide the prioritization and escalation of issues, ensuring that those with the greatest potential impact are addressed promptly.

Throughout the project, the Issue Management Plan will be a living document, updated as needed to reflect new issues, changes in process, or lessons learned. This approach ensures that issues are managed proactively and transparently, minimizing their impact on project objectives and supporting successful project delivery.

v. Deliverable Review and Approval Process (DRAP) Alivia will fully participate in the State’s Deliverables Review Process (DRAP) as provided during Project Initiation. We recognize that the DRAP governs how deliverables are submitted, reviewed, commented on, updated, and ultimately accepted by the State. Upon receipt of the State’s DRAP, Alivia will review the process in detail and, if appropriate, may propose changes for consideration; however, we understand that the State reserves the right to reject any proposed changes and make final decisions on the DRAP.

For each written deliverable, Alivia will prepare and submit a Deliverable Expectation Document (DED) for the State’s review and approval no later than 30 calendar days before the deliverable is due. We will not submit any written deliverable until the State has formally accepted the corresponding DED. We understand that submitting a deliverable prior to DED acceptance puts us at risk of having to redo the work without additional compensation, and we will strictly adhere to this requirement.

The DED will follow the content and outline requirements provided by the State during the DRAP. If we believe any modifications would improve clarity or project outcomes, we may propose changes to the DED, but we recognize the State’s right to reject any such proposals.

If any deficiencies are identified in a deliverable, Alivia will promptly investigate the source of the issue and correct it at no cost to the State. We will revise deliverables as needed, using the State’s review findings to ensure all content and format requirements are met. We understand that the State may decline to approve deliverables that are not reasonably acceptable, and that written acceptance from the State is required for all final deliverables in each project phase. No phase will be considered complete, and no payment will be made, until the State has provided written approval for all phase-specific deliverables.

This approach ensures that deliverable quality, transparency, and alignment with State expectations are maintained throughout the project lifecycle, and that Alivia remains fully accountable for meeting all deliverable requirements.

vi. Develop a Communication Plan Alivia will provide the State with a detailed and comprehensive Communication Plan within three weeks of the project kickoff meeting. This plan will be developed collaboratively with the State and will be maintained and updated throughout the project lifecycle. Any changes to the plan following initial approval will be submitted for review and approval by the designated State stakeholder(s).

The Communication Plan will define how critical project information is shared with stakeholders to ensure transparency, alignment, and timely decision-making. Alivia will work with the State to develop a stakeholder register and communication list, identifying who needs to receive specific types of information, how they will receive it, and how frequently.

Key components of the plan will include:

• Target Audiences: Alivia will identify and document all relevant stakeholder groups, including project team members, executive sponsors, State program staff, technical teams, and external partners. Each group’s communication needs and preferences will be considered.

• Communication Objectives: For each communication type, Alivia will define the purpose, whether it’s to inform, request input, report progress, escalate issues, or confirm decisions. This ensures that communications are purposeful and aligned with project goals.

• Communication Channels: Alivia will use a variety of channels tailored to the audience and message type, including email, Microsoft Teams, project dashboards, weekly status meetings, monthly executive briefings, and formal reports. Secure document repositories will be used for sharing deliverables and reference materials.

• Communication Schedule: The plan will outline the frequency and timing of communications. For example, weekly status meetings will be held with the core project team, bi-weekly customer success calls will provide updates on platform enhancements, and monthly reports will summarize progress, risks, and upcoming milestones.

• Communication Responsibilities: Roles and responsibilities will be clearly defined. The Alivia Project Manager will be the primary point of contact for day-to-day communications, while the Contract Manager will oversee executive-level engagement. State counterparts will be identified for each communication stream to ensure alignment and responsiveness.

• Feedback Mechanisms: Alivia will establish structured channels for stakeholder feedback, including meeting discussions, surveys, and direct outreach. Feedback will be documented, reviewed, and incorporated into project planning and execution as appropriate.

This Communication Plan will be a living document, reviewed regularly and updated as needed to reflect changes in stakeholder needs, project scope, or communication effectiveness. Alivia’s approach ensures that all stakeholders remain informed, engaged, and aligned throughout the project lifecycle.

vii. Develop a Staffing Plan Alivia will provide the State with a detailed and comprehensive Staffing Plan within three weeks of project kickoff. This plan will be developed in collaboration with the State and maintained throughout the project lifecycle, with any changes requiring review and approval by the designated State stakeholder(s).

The Staffing Plan will outline how Alivia will meet the human resource needs of the project, ensuring the right expertise and capacity are available at every phase. Here’s how Alivia will address each key aspect.

Staffing Process:

Alivia will ensure that staffing levels are sufficient to maintain high-quality service regardless of fluctuations in work volume. We will monitor project demands and adjust resource allocation as needed, drawing from a pool of qualified personnel. For vacancies in key personnel, Alivia will have a documented process for both temporary and permanent replacements. If a key position becomes vacant, a qualified substitute will be provided within ten State business days, and the State will be notified in writing at least fourteen days in advance of any planned changes, except in emergencies.

Resources: The plan will clearly define roles and responsibilities for all project resources, distinguishing between key and non-key personnel. Each role, such as Project Manager, Contract Manager, Business Analyst, System Administrator, Training/Documentation Manager, and Data Scientist, will have specific duties and reporting lines. Resource allocation will be detailed for both Alivia staff and any subcontractor staff, if applicable, ensuring clarity on who is responsible for each aspect of the project. Additionally, Alivia will confirm in writing that all individuals assigned to the project have passed our established background check criteria, which include criminal history, sex offender registry, and OIG/SAM exclusions. This process will be applied to any new staff assigned during the contract period.

Performance Issues:

The State will retain the right to release or request the replacement of any Alivia or subcontractor representative who is not performing to expectations. If this occurs, Alivia will provide an acceptable replacement within ten State business days of notice, ensuring continuity and quality of service.

Staffing Plan Changes:

Alivia will notify the State in writing at least fourteen days prior to any changes in key personnel, except in cases of immediate risk or security breaches. Key positions will not remain vacant for more than ten State business days without a qualified substitute.

The State will have the authority to approve or reject any proposed replacements and may interview or require verification of a candidate’s skills before approval. Alivia will not fill vacant key positions with other existing key personnel without State approval. This approach ensures that Alivia’s project team remains stable, qualified, and responsive to the State’s needs throughout the project, supporting successful delivery and ongoing partnership.

viii. Develop a Change Management Plan Alivia will provide the State with a detailed and comprehensive Change Management Plan within three weeks of project kickoff. This plan will be developed in collaboration with the State and maintained throughout the project lifecycle, with any changes requiring review and approval by the designated State stakeholder(s).

Change Management Process:

The plan will outline a clear, step-by-step process for submitting, evaluating, authorizing, managing, and controlling change requests. Any stakeholder, whether from Alivia or the State, can submit a change request using a standardized Change Request Form. Once submitted, each request will be logged in a Change Log and initially reviewed by the Project Manager. The request will then be evaluated for its impact on project scope, schedule, cost, quality, and risk. The evaluation process will include input from relevant subject matter experts and, when necessary, the State’s project leadership. Approved changes will be documented, communicated to all stakeholders, and incorporated into project plans and schedules. Rejected changes will also be documented with the rationale for rejection.

Roles and Responsibilities:

The Change Management Plan will clearly define roles and responsibilities. The Alivia Project Manager will be responsible for overseeing the change management process, maintaining the Change Log, and ensuring timely communication and implementation of approved changes. The State’s designated project lead will review and authorize changes that impact project scope, schedule, or budget. Subject matter experts from both Alivia and the State may be consulted as needed to assess the impact of proposed changes.

Change Request Form Template:

A standardized Change Request Form will be included in the plan. This template will capture essential information such as the description of the requested change, the reason for the change, the originator, the date submitted, the impact assessment, and the recommended action.

Change Log Template:

The plan will also include a Change Log template for collecting and tracking all change requests throughout the project. The log will record the status of each request (submitted, under review, approved, rejected, implemented), the responsible parties, and key dates for transparency and auditability.

Throughout the project, the Change Management Plan will be a living document, updated as needed to reflect new requirements, lessons learned, or process improvements. This approach ensures that all changes are managed in a controlled, transparent, and collaborative manner, minimizing disruption and supporting successful project delivery.

ix. Application Configuration and Maintenance Plan Alivia…

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