MAS - Advize Health LLC - 47QRAA22D00A2

4550 N Palmetto Ave. Unit 102, Winter Park, FL 32792 Tel: 813.569.2352 | Fax: 888.722.6059

ADVIZE HEALTH PRICE LIST

General Services Administration Federal Acquisition Service

Authorized Federal Supply Schedule FSS Price List Multiple Award Schedule (MAS)

Federal Supply Group: Professional Services

Contract Number: 47QRAA22D00A2 Contract Period: May 17, 2022 – May 16, 2027

Advize Health, LLC 4550 N Palmetto Ave

Unit 102 Winter Park, FL 32792 Phone: 516-326-7767

Website: https://advizehealth.com

Business Size: Woman-owned small business, HUBZone

Contact:

Jeanmarie Loria, CEO

Phone number: 813-569-2352 Email: jloria@advizehealth.com Fax Number: 1-888-722-6059

Price list current as of Modification #PA-0007 effective February 16, 2023

On-line access to contract ordering information, terms and conditions, up-to-date pricing, and the option to create an electronic delivery order are available through GSA Advantage!, a menu-driven database system. The Internet address for GSA Advantage! is http://www.GSAAdvantage.gov. For more information on ordering go to the following website: https://www.fss.gsa.gov/schedules

Table of Contents Advize Health Price List Customer Information Labor Category Pricing Labor Category Descriptions

Administrative Assistant Analyst I Analyst II Analyst III Analyst IV Auditor I Auditor II Biostatistician Coder Data Analyst I Data Analyst II Executive Fraud, Waste, and Abuse Subject Matter Expert Investigator Junior Consultant Legal Support I Legal Support II Legal Support III Physician Consultant I Physician Consultant II Principal Project Manager I Project Manager II Project Manager III Project Manager IV Quality Assurance Specialist I Quality Assurance Specialist II Senior Auditor I Senior Auditor II Senior Business Analyst Senior Consultant Subject Matter Expert I Subject Matter Expert II Trainer Final Proposal Review ................................................. Error! Bookmark not defined.

CUSTOMER INFORMATION

1a. Table of awarded special item number(s) with appropriate cross-reference to item descriptions and awarded price(s).

See awarded SINs and descriptions below. Awarded prices follow the Customer Information.

SIN SIN Descriptions 561450 Business Information Services 541990RISK Risk Assessment and Mitigation Services 541219 Budget and Financial Management Services 541110 Professional Legal Services 541211 Auditing Services 541611 Management and Financial Consulting, Acquisition and Grants Management Support, and Business Program and Project Management Service OLM Order-Level Materials

1b. Lowest priced model number and lowest unit price: Prices shown in the pricelist are for 1 hour. Discounts may be made available for quantity orders.

1c. Labor category descriptions: See descriptions beginning on page 9.

2. Maximum Order: $1,000,000.00

3. Minimum Order: $100.00

4. Geographic Coverage (delivery Area): Domestic Only

5. Point(s) of production (city, county, and state or foreign country): Same as company address

6. Discount from list prices or statement of net price: Prices shown in this pricelist are Government net prices and discounts have already been deducted.

7. Quantity discounts: None.

8. Prompt payment terms: NET 30 days. Information for Ordering Offices: Prompt payment terms cannot be negotiated out of the contractual agreement in exchange for other concessions.

9. Foreign items (list items by country of origin): None

10a. Time of delivery (Contractor insert number of days): To be negotiated per each delivery order.

10b.Expedited delivery: Contact Contractor

10c. Overnight and 2-day delivery: Contact Contractor

10d. Urgent requirements: Contact Contractor

11. F.O.B points(s): Destination

12a. Ordering address(es): Same as Contractor

12b. Ordering procedures: See Federal Acquisition Regulation (FAR) 8.405-3

13. Payment address(es): Same as company address

14. Warranty provision: Contractor’s standard commercial warranty

15. Export packing charges (if applicable): N/A

16. Terms and conditions of rental, maintenance, and repair (if applicable): N/A

17. Terms and conditions of installation (if applicable): N/A

18a. Terms and conditions of repair parts indicating date of parts price lists and any discounts from list prices (if applicable): N/A

18b. Terms and conditions for any other services (if applicable): N/A

19. List of service and distribution points (if applicable): N/A

20. List of participating dealers (if applicable): N/A

21. Preventive maintenance (if applicable): N/A

22a. Environmental attributes, e.g., recycled content, energy efficiency, and/or reduced pollutants: N/A

22b. If applicable, indicate that Section 508 compliance information is available for the information and communications technologies (ICT) products and services and show where full details can be found (e.g. contactor’s website or other location.) ICT accessibility standards can be found at:

https://www.Section508.gov.: N/A

23. Unique Entity ID number: L8LBTBXTNJM1

24. Notification regarding registration in the System for Award Management (SAM) database: Registered

Final Pricing: The rates shown below include the Industrial Funding Fee (IFF) of 0.75%.

LABOR CATEGORY PRICING

SINs Awarded Labor Category

Site Year 1 Year 2 Year 3 Year 4 Year 5

561450, 541990RISK,

541219,541110, 541211, 541611

Administrative Assistant**

Both $21.15 $21.78 $22.43 $23.10 $23.79

561450, 541990RISK,

541219,541110, 541211, 541611

Analyst I Both $95.67 $98.54 $101.50 $104.55 $107.69

561450, 541990RISK,

541219,541110, 541211, 541611

Analyst II Both $119.70 $123.29 $126.99 $130.80 $134.72

561450, 541990RISK,

541219,541110, 541211, 541611

Analyst III Both $154.61 $159.25 $164.03 $168.95 $174.02

561450, 541990RISK,

541219,541110, 541211, 541611

Analyst IV Both $254.39 $262.02 $269.88 $277.98 $286.32

561450, 541990RISK,

541219,541110, 541211, 541611

Auditor I Both $128.36 $132.21 $136.18 $140.27 $144.48

561450, 541990RISK,

541219,541110, 541211, 541611

Auditor II Both $272.92 $281.11 $289.54 $298.23 $307.18

561450, 541990RISK,

541219,541110, 541211, 541611

Biostatistician Both $219.45 $226.03 $232.81 $239.79 $246.98

561450, 541990RISK,

541219,541110, 541211, 541611

Coder Both $138.24 $142.39 $146.66 $151.06 $155.59

561450, 541990RISK,

541219,541110, 541211, 541611

Data Analyst I Both $124.06 $127.78 $131.61 $135.56 $139.63

561450, 541990RISK,

541219,541110, 541211, 541611

Data Analyst

II

Both $153.83 $158.44 $163.19 $168.09 $173.13

561450, 541990RISK,

541219,541110, 541211, 541611

Executive Both $234.41 $241.44 $248.68 $256.14 $263.82

Labor Category

Site Year 1 Year 2 Year 3 Year 4 Year 5

561450, 541990RISK,

541219,541110, 541211, 541611

Fraud, Waste, Abuse Subject Matter Expert

Both $115.81 $119.28 $122.86 $126.55 $130.35

561450, 541990RISK,

541219,541110, 541211, 541611

Investigator Both $100.71 $103.73 $106.84 $110.05 $113.35

561450, 541990RISK,

541219,541110, 541211, 541611

Junior Consultant

Both $93.76 $96.57 $99.47 $102.45 $105.52

561450, 541990RISK,

541219,541110, 541211, 541611

Legal Support I

Both $249.37 $256.85 $264.56 $272.50 $280.68

561450, 541990RISK,

541219,541110, 541211, 541611

Legal Support

II

Both $297.73 $306.66 $315.86 $325.34 $335.10

561450, 541990RISK,

541219,541110, 541211, 541611

Legal Support

III

Both $347.36 $357.78 $368.51 $379.57 $390.96

561450, 541990RISK,

541219,541110, 541211, 541611

Physician Consultant I

Both $276.94 $285.25 $293.81 $302.62 $311.70

561450, 541990RISK,

541219,541110, 541211, 541611

Physician Consultant II

Both $402.82 $414.90 $427.35 $440.17 $453.38

561450, 541990RISK,

541219,541110, 541211, 541611

Principal Both $194.07 $199.89 $205.89 $212.07 $218.43

561450, 541990RISK,

541219,541110, 541211, 541611

Project Manager I

Both $115.75 $119.22 $122.80 $126.49 $130.27

561450, 541990RISK,

541219,541110, 541211, 541611

Project Manager II

Both $145.37 $149.73 $154.22 $158.85 $163.62

561450, 541990RISK,

541219,541110, 541211, 541611

Project Manager III

Both $180.45 $185.86 $191.44 $197.18 $203.10

Labor Category

Site Year 1 Year 2 Year 3 Year 4 Year 5

561450, 541990RISK,

541219,541110, 541211, 541611

Project Manager IV

Both $279.29 $287.67 $296.30 $305.19 $314.35

561450, 541990RISK,

541219,541110, 541211, 541611

Quality Assurance Specialist I

Both $184.53 $190.07 $195.77 $201.64 $207.69

561450, 541990RISK,

541219,541110, 541211, 541611

Quality Assurance Specialist II

Both $209.47 $215.75 $222.22 $228.89 $235.76

561450, 541990RISK,

541219,541110, 541211, 541611

Senior Auditor I

Both $159.60 $164.39 $169.32 $174.40 $179.63

561450, 541990RISK,

541219,541110, 541211, 541611

Senior Auditor II

Both $184.53 $190.07 $195.77 $201.64 $207.69

561450, 541990RISK,

541219,541110, 541211, 541611

Senior Business Analyst

Both $169.57 $174.66 $179.90 $185.30 $190.86

561450, 541990RISK,

541219,541110, 541211, 541611

Senior Consultant

Both $129.67 $133.56 $137.57 $141.70 $145.95

561450, 541990RISK,

541219,541110, 541211, 541611

Subject Matter Expert I

Both $200.50 $206.52 $212.72 $219.10 $225.67

561450, 541990RISK,

541219,541110, 541211, 541611

Subject Matter Expert

II

Both $446.60 $460.00 $473.80 $488.01 $502.65

561450, 541990RISK,

541219,541110, 541211, 541611

Trainer Both $213.38 $219.78 $226.37 $233.16 $240.15

The Service Contract Labor Standards, formerly the Service Contract Act (SCA), is applicable to this contract as it applies to the entire Multiple Award Schedule and all services provided. While no specific labor categories have been identified as being subject to SCLS due to exemptions for professional employees (FAR 22.1101, 22.1102 and 29 CRF 541.300), this contract still maintains the provisions and protections for SCLS eligible labor categories. If and/or when the contractor adds SCLS labor categories/employees to the contract through the modification process, the contractor must inform the Contracting Officer and establish a SCLS matrix identifying the GSA labor category titles, the occupational code, SCLS labor category titles and the applicable WD number. Failure to do so may result in cancellation of the contract.

LABOR CATEGORY DESCRIPTIONS

ADMINISTRATIVE ASSISTANT

Minimum Year Experience: 0 years

Minimum Education: High School Diploma

Responsibilities: Provides general-purpose administrative and clerical support, including Health IT support, for project tasks. May include secretarial, word processing, graphics, desktop publishing, editing and coordination.

ANALYST I

Minimum Year Experience: 2 years

Minimum Education: Associate degree or equivalent experience

Responsibilities: Provides task unique functional expertise necessary to interpret requirements, ensures responsiveness and achieve successful performance; this may include subject matter, Health IT, and unique technical knowledge. Assists in analysis, evaluation, and implementation of systems. Possesses knowledge of applying analytic methodologies and principles to address project needs. Serves as a member of the project team performing analytical tasks and technical team assignments; performs research, support, and reporting functions.

ANALYST II

Minimum Year Experience: 3 years

Responsibilities: Provides task unique functional expertise necessary to interpret requirements, ensures responsiveness and achieve successful performance; this may include subject matter, Health IT, and unique technical knowledge. Assists in analysis, evaluation, and implementation of systems. Possesses knowledge of applying analytic methodologies and principles to address project needs. Serves as a member of the project team performing analytical tasks and technical team assignments; performs research, support, and reporting functions.

ANALYST III

Minimum Year Experience: 4 years

Minimum Education: Bachelor’s Degree or equivalent experience include subject matter, Health IT, and unique technical knowledge. Assists in analysis, evaluation, and implementation of systems. Possesses knowledge of applying analytic methodologies and principles to address project needs. Serves as a member of the project team performing analytical tasks and technical team assignments; performs research, support, and reporting functions.

ANALYST IV

Minimum Year Experience: 5 years include subject matter, Health IT, and unique technical knowledge. Assists in analysis, evaluation, and implementation of systems. Possesses knowledge of applying analytic methodologies and principles to address project needs. Serves as a member of the project team performing analytical tasks and technical team assignments; performs research, support, and reporting functions.

AUDITOR I

Responsibilities: Review working papers and reports for compliance with applicable standards and completeness. Conduct discussions with clients about the results of an audit. Review, coordinate, and approve work plans which may include Health IT audits.

Help resolve auditing, and reporting problems. Plan and execute audits. Independently performs major segments of an audit. Conduct compliance audits and inpatient and outpatient record reviews. Ability to read and analyze complex information including medical charts and other insurance documents. Ability to prepare objective, unbiased medical determinations for review. Familiarity with automated medical claims payment systems. Ensure compliance with all HIPAA requirements. Demonstrate an ability to constructively provide feedback to providers.

AUDITOR II

Responsibilities: Review working papers and reports for compliance with applicable standards and completeness. Conduct discussions with clients about the results of an audit. Review, coordinate, and approve work plans which may include Health IT audits.

Help resolve auditing, and reporting problems. Plan and execute audits. Independently performs major segments of an audit. Conduct compliance audits and inpatient and outpatient record reviews. Ability to read and analyze complex information including medical charts and other insurance documents. Ability to prepare objective, unbiased medical determinations for review. Familiarity with automated medical claims payment systems. Ensure compliance with all HIPAA requirements. Demonstrate an ability to constructively provide feedback to providers.

BIOSTATISTICIAN

Responsibilities: Provides expertise in biostatistics methods and statistical procedures, including application of biostatistics and/or computational computer technology to epidemiological studies, laboratory studies, prevention research, Health IT, and other selected forms of studies/research conducted and/or supported by clients. Requires knowledge and use of commercial statistical software packages and biostatistical methodologies for health data analyses. Experienced with sample size calculations and methodologies. Understanding of statistical methods including, but not limited to, linear, logistic, and conditional logistic regression models, as well as survey statistics and survival analysis. Duties also may include developing and running statistical models/algorithms, providing data analytics support for fraud investigations and/or hearings, oversee statistically-valid sampling and extrapolation, participate in ad hoc studies as requested. The Biostatistician is expected to lead and/or advise a team of other statisticians and analysts.

CODER

Responsibilities: Assemble record and ensure all required information is available for review, which may include Health IT. Validate appropriate elements required. Assign appropriate codes, e.g. E&M Codes, ICD-9 or ICD-10 diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), and modifiers.

DATA ANALYST I

Minimum Year Experience: 1 year

Responsibilities: Provide data analysis as a subject matter expert in support of detection, case development, remediation, and recovery of suspected overpayments, fraud, waste, and abuse accurately, which may include Health IT. Assess data integrity by evaluating, implementing, and managing compliance with financial, business, or medical specifications.

Conduct reviews of completed work to evaluate integrity of data analysis and findings.

DATA ANALYST II

Responsibilities: Provide data analysis as a subject matter expert in support of detection, case development, remediation, and recovery of suspected overpayments, fraud, waste, and abuse accurately, which may include Health IT. Assess data integrity by evaluating, implementing, and managing compliance with financial, business, or medical specifications. Conduct reviews of completed work to evaluate integrity of data analysis and findings.

EXECUTIVE

Responsibilities: Provides oversight and direction for large or complex efforts, including health IT efforts. Provides strategic input, oversees budget, project delivery and management.

Responsible for formulating and enforcing work standards, assigning contractor schedules, reviewing work discrepancies, and supervising project staff. Directs the development of project goals, work plans, timeliness, development and implementation of project strategies. Serves as the contractor's contract manager, and may act as the contractor's authorized interface with the Government Contracting Officer (CO), the contract level Contracting Officer's Representative (COR), government management personnel and customer agency representatives. Responsible for the overall contract performance.

FRAUD, WASTE, AND ABUSE SUBJECT MATTER EXPERT

Responsibilities: Subject matter expert on a project leading the development of technical solutions in areas such as program evaluation, program integrity, statistical and data analysis, health IT, etc. This person may report to the Project Manager and is responsible to develop solutions required in the project while maintaining alignment with project strategy and overall objectives. This is a veteran consultant with experience in relevant business and management challenges and solutions relevant to government programs such as Medicare and Medicaid.

Maintains strong and current working knowledge of current standards and guidelines, regulatory and compliance requirements and updates, trends in areas such as fraud, waste and abuse and other specific and technical areas of expertise. Depending on the specific project, the FWA SME may lead training requirements relevant to the consultant’s expertise. This person has the ability to work with stakeholders, clients and other employees at all levels to achieve results. This person demonstrates high levels of enthusiasm, initiative and creative problem solving to meet the objectives of the project. The FWA SME is able to communicate effectively to all levels of staff both orally and in writing. This person may also fulfill supervisory duties.

INVESTIGATOR

Responsibilities: Develops workflows to centralize all internal and external touch point processes where possible fraud, waste and abuse occurrences might be reported or found.

Develops data mining activities with the assistance of Health Care Informatics and Information Technology that identify anomalies within the structure/content of health care data, including but not limited to claims, providers, and members. Performs detailed investigation of all suspected and reported instances and maintain records accordingly. Investigates and evaluates insurance claims, properly researches and secures all available evidentiary documentation. Conducts in-person and/or telephonic interviews / recorded statements, accident scene investigation / documentation, investigation, subrogation investigation, background investigation. Initiates and responds to client communication. Prepares written reports of findings.

JUNIOR CONSULTANT

Minimum Education: High School Diploma

Responsibilities: The Junior Consultant provides analytical and research support in specifically assigned tasks within the project’s scope of work. The Junior Consultant assists in monitoring the status and progress of work and coordinates necessary adjustments with the Project Manager in accordance with established priorities. The Junior Consultant may have other duties assigned necessary to accomplish specific tasks in analysis. This person demonstrates high levels of enthusiasm, initiative and creative problem solving to meet the objectives of the project. The Junior Consultant is able to communicate effectively to all levels of staff both orally and in writing.

LEGAL SUPPORT I

Responsibilities: Responsible for providing legal support to staff in cases and administrative projects. Acts as a point of contact for client’s outside counsel in collecting case materials;

Assists attorneys in carrying out legal research, including gathering and analyzing research data, such as statutes, decisions, legal arguments, codes, and documents. Assists attorneys in drafting legal documents, including contracts, subpoena responses, preservation memoranda, and statements. Assists attorneys in investigating facts and laws of cases, and search pertinent sources to determine causes of action and prepare cases. Assist attorneys in interviewing witnesses and scheduling depositions. Other special projects, legal support tasks, and administrative duties as needed.

LEGAL SUPPORT II

projects. Partners with the client's group and assist with matters. Acts as a point of contact for client’s outside counsel in collecting case materials; Assists attorneys in carrying out legal research, including gathering and analyzing research data, such as statutes, decisions, legal arguments, codes, and documents. Assists attorneys in drafting legal documents, including contracts, subpoena responses, preservation memoranda, and statements. Assist attorneys in interviewing witnesses and scheduling depositions. Other special projects, legal support tasks, and administrative duties as needed.

LEGAL SUPPORT III

projects. Partners with the client's group and assist with matters. Acts as a point of contact for client’s outside counsel in collecting case materials; Monitors and update cases through an internal case management system, noting deadlines and major case updates. Assists attorneys in carrying out legal research, including gathering and analyzing research data, such as statutes, decisions, legal arguments, codes, and documents. Assists attorneys in drafting legal documents, including contracts, subpoena responses, preservation memoranda, and statements.

Preparing cases for attorneys by organizing exhibits, finalizing affidavits and legal correspondences, and maintaining documents in paper and electronic filing systems. Assists attorneys in investigating facts and laws of cases, and search pertinent sources to determine causes of action and prepare cases. Assist attorneys in interviewing witnesses and scheduling depositions. Other special projects, legal support tasks, and administrative duties as needed.

PHYSICIAN CONSULTANT I

Minimum Education: Medical Degree

Responsibilities: Board –certified clinical psychologist or professional counselor to provide consulting services which may include Health IT, independent document review, and/or sworn testimony, in person or by verbal or written report. This may include review of forensic work of other professionals to assist in development of legal strategy for cases. Complete review of medical records and respond to clarifications when original records were not complete or additional findings have been issued.

PHYSICIAN CONSULTANT II

Minimum Education: Medical Degree

Responsibilities: Senior level, board –certified clinical psychologist or professional counselor to provide consulting services, independent document review, and/or sworn testimony, in person or by verbal or written report. This may include review of forensic work of other professionals to assist in development of legal strategy for cases. Complete review of medical records and respond to clarifications when original records were not complete or additional findings have been issued.

PRINCIPAL

Responsibilities: Manages a staff of large to moderate size in the everyday tasks of an office setting.

Making decisions independently on all problems in an administrative office environment. Projects may include Health IT projects.

PROJECT MANAGER I

Responsibilities: The Project Manager coordinates and manages day-to-day tasks and processes necessary for near-term project deliverables to be executed. This person may aid the Project Manager II and Project Manager III to coordinate and drive execution of tasks involving intense levels of resources that may be distributed across geographies and subcontractors. The Project Manager guides the project as a whole through development of systems, procedures, policies and processes for special tasks necessary to interface with internal and external teams, including Health IT projects.

PROJECT MANAGER II

Responsibilities: Maintains the day-to-day management and coordination of projects including Health IT projects. In managing the project, the Project Manager II is responsible to identify and manage the resource needs in order to accomplish the scope of work. The Project Manager II monitors the status and progress of work of the project team and makes day-to-day adjustments in accordance with established priorities. The Project Manager II prepares and submits routine reports to the customer’s responsible point-of-contact regarding the project’s status and performance to include near-term and long-term needs and risks. This person has the ability to work with stakeholders, clients and other employees at all levels to achieve results.

PROJECT MANAGER III

Responsibilities: Maintains the day-to-day management and coordination of projects, including Health IT projects. In managing the project, the Project Manager II is responsible to identify and manage the resource needs in order to accomplish the scope of work. The Project Manager II monitors the status and progress of work of the project team and makes day-to-day adjustments in accordance with established priorities. The Project Manager II prepares and submits routine reports to the customer’s responsible point-of-contact regarding the project’s status and performance to include near-term and long-term needs and risks. This person has the ability to work with stakeholders, clients and other employees at all levels to achieve results.

PROJECT MANAGER IV

Minimum Year Experience: 7 years

Responsibilities: Primary liaison with the customer and maintains the day-to-day management and coordination of the more complex projects, including Health IT projects. In managing the project, the Project Manager IV is responsible to identify and manage the resource needs in order to accomplish the scope of work. Additionally, the Project Manager leads individual team members to ensure timely and accurate delivery of work products along established deadlines and consistent with the overall project plan. The Project Manager monitors the status and progress of work of the project team and makes day-to-day adjustments in accordance with established priorities. The Project Manager III prepares and submits routine reports to the customer’s responsible point-of-contact regarding the project’s status and performance to include near-term and long-term needs and risks. The Project Manager is also responsible to manage communications internal to the project team to include all subcontractors engaged on the project. This person has the ability to work with stakeholders, clients and other employees at all levels to achieve results. This person demonstrates high levels of enthusiasm, initiative and creative problem solving to meet the objectives of the project. The Project Manager is able to communicate effectively to all levels of staff both orally and in writing.

QUALITY ASSURANCE SPECIALIST I

Responsibilities: Responsible for implementing a program of reporting, tracking, and analyzing quality measures. Monitor quality procedures. Perform random checks to assure adherence to quality assurance guidelines. Provide technical and grammatical support for written documentation, including for Health IT projects. Provides senior-level direction or supervision on projects involving quality management systems development and implementation, including gap analyses, assessments, cost analysis, needs assessments, business case development and integration. Responsible for implementing a program of reporting, tracking, and analyzing quality measures. Monitor quality procedures.

QUALITY ASSURANCE SPECIALIST II

Responsibilities: Responsible for implementing a program of reporting, tracking, and analyzing quality measures. Monitor quality procedures. Prepare studies, plans, and analyses in support of project personnel and goals. Perform random checks to assure adherence to quality assurance guidelines.

Provide technical and grammatical support for written documentation, including for Health IT projects.

Provides leadership and technical or functional expertise necessary to plan and implement projects and interventions that are highly technical and require significant coordination and cooperation among stakeholders and others. Possesses specialized expertise in technical and organizational areas.

Provides senior-level direction or supervision on projects involving quality management systems development and implementation, including gap analyses, assessments, cost analysis, needs assessments, business case development and integration. May conduct complex reviews and provide training opportunities. Responsible for implementing a program of reporting, tracking, and analyzing quality measures. Monitor quality procedures. Prepare studies, plans, and analyses in support of project personnel and goals. Perform random checks to assure adherence to quality assurance guidelines.

Provide technical and grammatical support for written documentation.

SENIOR AUDITOR I

Minimum Education: Associate Degree or equivalent experience

Responsibilities: Conduct compliance audits and inpatient and outpatient record reviews.

Ability to read and analyze complex information including medical charts and other insurance and claims documents. Ability to prepare objective, unbiased medical determinations for review.

Familiarity with automated medical claims payment systems to include Heath IT. Ensure compliance with all HIPAA requirements. Demonstrate an ability to constructively provide feedback to providers. Use expertise in a complex, specific subject matter area to define problems and develop plans and requirements for successful completion of a project. Conduct reviews of previously analyzed medical claims or records for quality assurance.

SENIOR AUDITOR II

Responsibilities: Conduct compliance audits and inpatient and outpatient record reviews.

Ability to read and analyze complex information including medical charts and other insurance and claims documents. Ability to prepare objective, unbiased medical determinations for review.

Familiarity with automated medical claims payment systems to include Heath IT. Ensure compliance with all HIPAA requirements. Demonstrate an ability to constructively provide feedback to providers. Use expertise in a complex, specific subject matter area to define problems and develop plans and requirements for successful completion of a project. Conduct reviews of previously analyzed medical claims or records for quality assurance.

SENIOR BUSINESS ANALYST

Responsibilities: Analyzes and assesses issues influencing project completion; and lead roles on project work streams, including Health IT projects. Uses extensive business knowledge and effective communication skills to facilitate and elicit requirements for projects, while effectively managing changes and conflicts during specifications gathering process. Works directly with end users to evaluate customer or plan needs. Conducts the analysis and documentation of current state and future state, documenting user requirements in the design of the future state workflows, to optimize system functionality. Develops business process artifacts (process flow, work state diagrams, etc.) as they pertain to enterprise-level processes, spanning multiple functional areas. Develop use cases, test scenarios, test cases, clearly communicate testing methodologies and apply testing methodologies to ensure application quality. Reviews requests to ensure consistency and compatibility to existing systems and procedures, including researching, validating, and resolving issues, for accurate processing of information. Creates status of tasks, as well as risks and issues. Troubleshoots technical issues, and identifies modifications needed in existing applications to meet changing user and regulatory requirements.

SENIOR CONSULTANT

Responsibilities: The Senior Consultant provides high-level analysis and advisory services in the planning, coordination and implementation phases of the scope of work, including Health IT.

The Senior Consultant assists in monitoring the status and progress of work and coordinates necessary adjustments with the Project Manager in accordance with established priorities. The Senior Consultant is also tasked to perform research and analysis on projects pertaining to their specific area of expertise. The Senior Consultant maintains effective and current working knowledge of current standards and guidelines, regulatory and compliance requirements and updates, trends in areas such as fraud, waste and abuse and other specific and technical areas of expertise. Depending on the specific project, the Senior Consultant may lead training requirements relevant to the consultant’s expertise. This person has the ability to work with stakeholders, clients and other employees at all levels to achieve results.

SUBJECT MATTER EXPERT I

Responsibilities: Has experience in translating strategic plans, including Health IT, into action plans according to relevant standards and policies, developing resource needs, developing continuous improvement strategies, improving organizational performance, and developing improvement to business or financial process management. Maintain specialized knowledge of organizational issues and processes related to the best practices for implementing complex business change.

SUBJECT MATTER EXPERT II

Minimum Year Experience: 10 years

Minimum Education: Master’s Degree or equivalent experience

Responsibilities: Defines the problems and analyzes and develops plans and requirements in the subject matter area for moderately complex to complex systems. Coordinates and manages the preparation of analysis, evaluations, and recommendations for proper implementation of programs and systems specifications.

TRAINER

Responsibilities: Develops advanced concepts, techniques, and standards. Implements and operates in-house programs, practices, and procedures for developing optimal utilization of personnel. Develops tests and visual aids. Coordinates class arrangements, conducts training classes, and develops criteria for evaluating effectiveness of training activities. Keeps abreast of training and development research: learning theory, motivation theory, and new materials, methods, and techniques. If required, may use technical expertise to assist in training.

Advize Health uses the following equivalencies:

Degree Experience Equivalence Other Equivalence

Associate Two years’ relevant experience Technical Certification

Bachelor’s Associate degree and two years’ relevant experience, or four years of relevant experience

Professional certification

Master’s Bachelor’s degree and two years of relevant experience, or Associate degree and four years of relevant experience, or six years of relevant experience

Professional license

Doctorate Master’s degree and two years of relevant experience, or Bachelor’s and four years of relevant experience, or Associate’s degree and six years of relevant experience, or eight years of relevant experience

Ex: Associates Degree equal to two years relevant experience.