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Attachment E: Vendor Operations Performance Report Card
| Report Card # |
| Category |
| Report Card Performance Requirement |
| Status (Met/Not Met) |
| 1.B.001 |
| Agenda and Minutes |
| Prepare agendas and other materials (as appropriate) and distribute agendas and materials two (2) business days prior to the event. |
Prepare meeting minutes for all Vendor-led or DMS-requested meetings and distribute within two (2) business days of the meeting event.
Provide sufficiently qualified business and technical staff to document decisions, actions, and minutes from each meeting.
| 1.B.002 |
| Auditing |
| Perform audits as requested. |
| 1.B.003 |
| Call Center Establishment |
| Provide toll-free telephone and facsimile access to support program initiatives Monday through Friday (excluding Federal holidays) during, at minimum, the hours of 8:00 a.m. through 6 p.m. Eastern Time. |
| 1.B.004 |
| Change Control – CMS Requirements |
| Implement changes to accommodate any CMS requirements related to rebate management within three (3) business days, at no additional cost to DMS. This is situational and is determined on a case-by-case basis by DMS. |
| 1.B.005 |
| Change Control-Process |
| Perform systems maintenance and modifications, as specified in this RFP, for all component parts of the solution, as required by DMS within the mutually agreed-upon timeframes. |
Document new Change Control items within two (2) business days from the date that the Change Control items are identified.
Provide a full impact assessment within ten (10) business days from the date that the Change Order is logged.
| 1.B.006 |
| Change Control - Process Time Limit |
| Process DMS-required changes (CCMs) within thirty (30) calendar days, unless otherwise approved. |
| 1.B.007 |
| Change Control- Request Tracking |
| Maintain a Change Control Process that tracks requests. |
| 1.B.008 |
| Corrective Action Plan - Development |
| Develop a Corrective Action Plan, subject to DMS approval, in writing within twenty-four (24) clock hours for each identified deficiency that cannot be corrected within the same business day. |
| 1.B.009 |
| Document Standards |
| For any performance falling below a Commonwealth-specified level, the Vendor should explain the problems and identify the corrective action to improve the rating. The Vendor should provide a written response to DMS inquiries within two (2) calendar days. |
| 1.B.010 |
| Payment - Distribution |
| Paychecks or EFTs should be issued to employees, at a minimum, every other week, on a certain identified date, which Vendors should specify in advance. (For example, every other Friday or the 14th and 30th.) |
| 1.B.011 |
| Payment - Reconciliation |
| Reconcile account statements and submit with documentation to DMS on a certain identified date, which Vendors should specify in advance. |
| 1.B.012 |
| Program Management - Business Improvement Plan Assessment |
| Present a quarterly assessment of the Business Improvement Plan (BIP) within fifteen (15) business days following the end of each quarter throughout the life of this contract. An agenda should be provided to DMS five (5) business days in advance of the presentation for approval. |
| 1.B.013 |
| Program Management - Business Improvement Plan Creation |
| Prepare an annual BIP and submit the proposed plan to DMS at least sixty (60) calendar days prior to the end of each calendar year. |
| 1.B.014 |
| Program Management - Project Management Framework |
| Work with DMS to review and continuously improve processes, tools, templates, and standards to meet the needs of the project |
Ensure all staff adhere to the plans/processes as defined in the DMS Project Management Framework. DMS approval is required for any exceptions.
| 1.B.015 |
| Program Management - Quality Assessments |
| Present quarterly results regarding quality assessment of each functional area to DMS within thirty (30) calendar days of the end of the quarter. |
| 1.B.016 |
| Program Management - Quality Improvement Plan |
| Prepare an annual Quality Improvement Plan (QIP) and submit at least sixty (60) calendar days prior to the end of the calendar year. |
| 1.B.017 |
| Project Management - RAID Documentation |
| Document new risks, issues, key decisions, and action items within two (2) business days from the date they are identified. This includes clearly documenting the risk, issue, decision, and/or action item, establishing an owner, and establishing a target due date. |
| 1.B.018 |
| Reporting - Ad Hoc Reports |
| Provide ad hoc reports within the timeframe defined in the RFP requirements. |
| 1.B.019 |
| Reporting - Audit Results |
| Deliver an audit report to DMS within thirty (30) calendar days of an individual audit. |
| 1.B.020 |
| Reporting - Call Center - Answer Speed |
| Provide Call Center reports by the 15th of the following month, including average answer speed in seconds. |
| 1.B.021 |
| Reporting - Call Center - Call Abandonment |
| Provide Call Center reports by the fifteenth (15th) of the following month, including Call abandonment rate and average abandon time. |
| 1.B.022 |
| Reporting - Call Center - Downtime Expected |
| Provide Call Center reports by the fifteenth (15th) of the following month, including total clock hours of daily call center access and any downtime experienced. |
| 1.B.023 |
| Reporting - Call Center - Inquiry Method |
| Provide Call Center reports by the fifteenth (15th) of the following month, including total number of inquiry requests received via telephone, facsimile, and USPS. |
| 1.B.024 |
| Reporting - Call Center - Talk Time |
| Provide Call Center reports by the fifteenth (15th) of the following month, including average ACD talk time per call of total calls handled. |
| 1.B.025 |
| Reporting - Complaints |
| Report monthly total number, type, and detail of each complaint from Members and Providers. |
| 1.B.026 |
| Reporting - Performance Monitoring |
| Continuously monitor and produce a monthly report during Operations & Maintenance (O&M) for the following items: |
• The system website response time should be within five (5) seconds for ninety-nine percent (99%) of the time.
• System response time should be less than or equal to five (5) seconds for all inquiry and update screens, as measured on the production environment.
• Contract Requirements failures.
| 1.B.027 |
| Reporting - Report Card Delivery |
| Produce and deliver report card on performance. |
| 1.B.028 |
| Employee Onboarding |
| The onboarding process of a new employee should not take longer than thirty (30) days, unless the FMA can attest to delays outside of their control such as incomplete packet submission, the submission of inaccurate employee information or delays by the employee to submit required background checks. |
| 1.B.029 |
| Security - Annual Risk Assessment |
| Perform risk assessment every three hundred and sixty-five (365) calendar days. |
| 1.B.030 |
| Security - SSAE Audit |
| Annual SSAE 18 audit. |
| 1.B.031 |
| Security - Third Party Assessment |
| Perform a third party security assessment every three hundred and sixty-five (365) calendar days. |
| 1.B.032 |
| Staffing - Organizational Change |
| Submit organization chart annually or within thirty (30) business days of change. |
| 1.B.033 |
| Staffing - Staff Duty Reallocation Plan |
| Within ten (10) business days of receiving an individual’s resignation notice, the Vendor’s notice to terminate an individual, or a position becomes vacant, the Vendor should provide a detailed plan specifying how work is to be completed until replacement staff is hired. DMS reserves the right to approve or reject the plan. |
| 1.B.034 |
| Staffing - Staff Replacement Notification |
| Provide resumes to DMS for the top three (3) candidates within thirty (30) calendar days after a vacancy occurs. |
| 1.B.035 |
| Staffing - Staffing Levels |
| Ensure the appropriate experienced staffing level is maintained throughout the project to ensure objectives are met on time and with quality. |
Maintain staffing levels throughout the project at ninety percent (90%) or more of the Staffing Plan.
Ensure Vendor staff have the appropriate experience and are dedicated to the project in accordance with the approved Staffing Plan and their role in the Project Plan.
| 1.B.036 |
| Staffing - Vacancy Notification |
| Provide written notification to DMS of anticipated vacancies of key staff within two (2) business days of receiving the individual’s resignation notice, the Vendor’s notice to terminate an individual, or the position becomes vacant. |
| 1.B.037 |
| System Performance - Call Center |
| Adhere to the Call Center guidelines outlined in the contract. |
| 1.B.038 |
| System Performance – EVV & Payroll Issues |
| Resolve any issues related to EVV and payroll within three (3) business days. If resolution is not possible within that timeframe, the Vendor should provide updates to DMS on the situation every 24 hours until resolved. |
| 1.B.039 |
| System Performance - File Delivery |
| Deliver claims files following every other Friday claims process cycle at a minimum. |
| 1.B.040 |
| System Performance - Help Desk Availability |
| Help desk available Monday through Friday (excluding Federal holidays) during, at minimum, the hours of 8:00 a.m. through 6 p.m. Eastern Time. |
| 1.B.041 |
| System Performance - Maintenance Problem Creation |
| Correct system maintenance problems within five (5) business days or correction date approved by DMS. |
| 1.B.042 |
| System Performance - Member Profile Update |
| Update member profiles, including demographics as needed. |
| 1.B.043 |
| System Performance - Staff Access |
| Maintain the system so that DMS and all staff have access to it within agreed upon response times. |
| 1.B.044 |
| System Performance - Web Availability |
| Access to web (for DMS, employees, participants) twenty-four (24) hours, seven (7) days a week, three hundred and sixty-five (365) days (24/7/365) a year, except for approved down time. |