DIR_RFP_17546_Exhibit_J_Current_and_Future_Claims_Interface.xlsx
XLSX spreadsheet 59 KB Posted
- Solicitation number
- 17546
- Issued by
- California
About this file
This is an interface requirements specification document for the DIR EAMS Claims Benefit Administration System, developed by the Department of Industrial Relations (DIR) and the Division of Workers' Compensation (DWC). The document outlines both current and future system interfaces necessary to support claims management and benefit administration operations. The specification details three current interfaces: FileNet for document retrieval, Curam for case management and workflow tracking, and IBM Cognos Analytics for reporting and data analysis. These existing interfaces handle real-time transactions, on-demand processing, and reporting functions with monthly volumes ranging from 11 to 100 users, supporting case data, claimant information, and payment data elements.
The future interface requirements specify ten integration capabilities essential for system expansion and modernization. Key requirements include integration with BigQuery and Looker for advanced analytics and interactive dashboards, implementation of eSignature capabilities either built-in or through third-party solutions, and comprehensive Data Lake integration for legacy data migration, historical reference, and continuous post-go-live reporting. Additional requirements mandate data archiving compliance within the DIR's Google Cloud Platform environment, establishment of the Claims Benefit Administration System as the system of record with near real-time data transfer capabilities, integration with DIR's court application system, Document Management System (BOX) integration for unstructured data storage and retrieval, and implementation of unified analytics encompassing both structured and unstructured data. All integrations must incorporate role-based access controls and maintain audit functionality to track user access and ensure regulatory compliance with DIR and DWC policies.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| DIR_RFP_17546_Exhibit_D_Cost_Workbook.xlsx | XLSX spreadsheet | |
| EXHIBIT_B_Functional_Non-functional_Claims_Requirements.xlsx | XLSX spreadsheet | |
| DIR_RFP_17546_EAMS_CLAIMS_F260102.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Definitions
| INTERFACE DETAILS |
| Bidder's Name: |
DIR EAMS Claims Benefit Administration System Current and Future Interface Requirements Instructions
| Tab-Definitions | ||
| Row 2 | Bidder must input their company name in Cell B2. | |
| Tab Current Interface Details | The Current Interface Details are captured in this tab | |
| Tab Future Interface Details | The Future Interface Details are captured in this tab |
Current Interface Details
| The purpose of this document is to summarize detailed interface requirements for the new EAMS system. All information is based on inputs from EAMS project team under DIR. The approaches and considerations included in this document are preliminary and may be further developed based on additional inputs from DIR/DWC EAMS Project team. | ||||||||||||
| INTERFACE# | Source | Current interfaces | Direction | Type | Request | Response | Complexity | Frequency | Monthly Volume | Data Elements | Transaction | |
| INT01 | FileNet | FileNet: It is an enterprise content management (ECM) platform developed by IBM that helps organizations manage large volumes of documents, records, and other content. | Request/Response | Link | Initiate request from Curam case | Provide a list of case documents along with their metadata. | High | Real time | 30.531(size) | Case id, document id, filing date etc | Case document retreival | |
| INT02 | Curam | Curam: Case Management/ Workflow Management : i)Track, manage claims, disputes, and medical reports for injured workers. | ||||||||||
| It ensures efficient handing of cases, compliance with regulations and timely resolution of claim for both employees and employers. ii)Automation and organization of tasks, activties, and processes within a system | Case management is a part of CURAM. There is no direction because this is not an interface. | Component within CURAM | No request/response mechanism | No request/response mechanism | High | On-demand | 100 internal (DWC) users. | Case id, case type, status, notes, actions | Update, track, manage case data | |||
| INT03 | IBM Cognos Analytics | IBM Cognos Analytics: Data from the EAMS Transactional database is extracted, transformed, and loaded (ETL) into the EAMS Reporting database, and is used to drive business decisions by fulfilling requests for data extract, reporting and analysis of aggregated data. | Pull | web/app server | Data extract/reporting requests | Reports; dashboards | Medium | Real-time | 11 | case data, claimantdata, payment data etc | Reporting and Analytics |
Future Interface Details The purpose of this document is to summarize detailed interface details for the new EAMS system. All information is based on inputs from EAMS project team under DIR.
The approaches and considerations included in this document are preliminary and may be further developed based on additional inputs from DIR/DWC EAMS Project team.
| INTERFACE # | REQUIREMENTS |
| INT01 | Title: Integration with BigQuery and Looker |
Description: Claims Benefit Administration System must support integration with BigQuery for advanced data processing and analytics, and with Looker as the front-end visualization tool to provide interactive dashboards and visual insights for users.
INT02 Title: Inbuilt or Integrated eSignature Capability within Claims Benefit Administration System
Description: Claims Benefit Administration System must either have an inbuilt electronic signature (eSignature) tool or support integration with trusted third-party eSignature solutions.
INT03 Title: Data Lake Integration for Migration, Historical Reference, and Reporting
Description: Claims Benefit Administration System must support integration with a Data Lake to store legacy DWC data for migration and historical reference. After go-live, data from the Claims Benefit Administration System should continuously flow into the Data Lake to support reporting and dashboards. Access must be restricted to authorized DWC users through role-based access controls. The exact migration and conversion approach will be finalized during project execution.
INT04 Title: Data Archiving Compliance with DIR/DWC Requirements in GCP
Description:
Ensure all data archiving processes are fully aligned with DIR/DWC business requirements and are implemented securely within the DIR’s Google Cloud Platform (GCP) environment. This includes adhering to regulatory, retention, and access control standards as defined by DIR and DWC policies.
INT05 Title: System of Record and Data Integration with DIR GCP Environment
Description: Claims Benefit Administration System will serve as the system of record, consolidating all structured data. It must support near real-time data transfer to the DIR Data Lake hosted on Google Cloud Platform (GCP). Users (internal and external) should be able to store, access, and retrieve unstructured data through a centralized document management system via APIs (e.g., Apigee), accessible through the Claims Benefit Administration System user interface. Reporting and analytics will leverage tools such as Google BigQuery, Looker. Data archiving must align with DIR/DWC business requirements and be implemented within the DIR's GCP environment.
INT06 Title: Claims Benefit Administration System Integration with DIR court application
Description: Claims Benefit Administration System must integrate with the Court Case Management System to enable secure, real-time exchange of claim and case information, ensuring data consistency and improving workflow efficiency between both systems.
INT07 Title: Claims Benefit Administration System integration capability with Document Management Systems
Description: The Contractor shall integrate the production Claims solution with the EDMS (BOX) and ensure that all unstructured data is accurately stored and fully retrievable within the EDMS (BOX) environment. The Contractor shall maintain a unique identifier for each document and implement audit functionality to track and record user access to all documents. Additionally, the Contractor shall develop the Unified Analytics solution, encompassing both structured and unstructured data, in accordance with the final requirements provided by the DIR team.
INT08 Title: Data Lake Integration for Migration, Historical Reference, and Reporting
Description: Claims Benefit Administration System application must support integration with a Data Lake to store legacy DWC data for migration and historical reference. After go-live, data from the Claims Benefit Administration System should continuously flow into the Data Lake to support reporting and dashboards. Access must be restricted to authorized DWC users through role-based access controls. The exact migration and conversion approach will be finalized during project execution.
INT09 Title: Data Archiving Compliance with DIR/DWC Requirements in GCP
Description: Ensure all data archiving processes are fully aligned with DIR/DWC business requirements and are implemented securely within the DIR’s Google Cloud Platform (GCP) environment. This includes adhering to regulatory, retention, and access control standards as defined by DIR and DWC policies.
INT10 Title: System of Record and Data Integration with DIR GCP Environment
Description: Claims Benefit Administration System application will serve as the system of record, consolidating all structured data. It must support near real-time data transfer to the DIR Data Lake hosted on Google Cloud Platform (GCP). Users (internal and external) should be able to store, access, and retrieve unstructured data through a centralized document management system via APIs (e.g., Apigee), accessible through the Claims Benefit Administration System user interface. Reporting and analytics will leverage tools such as Google BigQuery, Looker. Data archiving must align with DIR/DWC business requirements and be implemented within the DIR's GCP environment.
File details come from the government source that posted it. Updated .