CARRIER COORDINATION TEAM Plan for Operations Committee

Transcription

1 CARRIER COORDINATION TEAM 2015 Plan fr Operatins Cmmittee

2 Overview The CCT supprts the technical and transactinal interfaces fr ur carrier business partners In 2015, we plan t transitin respnsibilities fr the CCT frm CGI t C4 staff where: We can build the capability in a reasnable time There is a lng term need fr this capability and we are nt recruiting persnnel we will nt need in futures We can reduce cst CGI has cmmitted t supprting C4 in this, with limited training, handver and technical supprt Gal is fr C4 t be self-sufficient in the areas it needs NOTE: This team will nt be respnsible fr crrectin r testing f defects in CGI s cde, nr will we be billed fr supprt hurs needed t assist carriers in wrking thrugh issues related t these defects 2

3 Nv/Dec: First EDI recrds sent t carriers (initial 834s) Histry Jan/ Feb: Carrier respnse team (5 FTEs) established in service center t handle ne-ff escalatins frm custmers regarding C4HCO / Carrier issues March / May: Carriers begin escalating EDI and peratinal issues t the C4HCO Carrier Team (Cheryl and Cliff) and the C4HCO EDI SME (Tm) Jan -Jun: CGI perfrms ad-hc EDI testing with carriers under warranty fr additinal EDI types (change recrds, payment web services, 820s) nt included in Oct 2013 release. July Oct: C4HCO and CGI rlled ut crdinated wave testing apprach with all carriers and cnslidated all carrier peratinal and EDI supprt activities int Carrier Crdinatin Teams (CCT) staffed primarily by CGI and funded under warranty until ne carrier was live with each f the fllwing critical services: 820s, payment web services, change EDI fr individual, change EDI fr SHOP Oct - Dec: CCT and carriers fcus n recnciliatin and renewals planning and testing. EDI testing paused. CCT funding prvided by Service Center and M&O budgets. 2 C4HCO Staff allcated t CCT team May/June: FY2015 budget defined July Oct: C4HCO believes that carrier EDI testing can be cmpleted in less than 5 mnths with cncentrated effrt frm all parties. Octber: After 3 mnths f intense testing with carriers, 1 carrier ges live with SHOP change EDI and anther 1 carrier ges live with IND change EDI, several carriers live with PWS and 820s Aug Dec: Increasing number f issues and escalatins between C4HCO and carriers fr peratinal / EDI issues. Started weekly and daily calls with carriers t address issues. CCT is key t reslving issues with individual carriers. Nv Dec: C4HCO and CGI develp frecast fr nging CCT team and discuss /funding and staffing ptins. Request fr funding / cntract apprval initiated.

4 The resurce need fr the Carrier Crdinatr Team will vary thrugh 2015 Activity Current FTEs Ptential fr transitin t C4 CGI resurce cst Ntes Carrier crdinatr lead 3.00 High High Relatinship with carriers shuld be wned by C4. Requires PM expertise. Resurce need cnstant. Carrier validatin and transitin t prductin (EDI Change, 820, Carrier Fee Billing, PWS testing, 834 audit) 2.75 High High Resurce need will rise after OE. Gd candidate t transitin but supprt fr C4 will be needed initially. EDI Change currently being perfrmed by C4. Carrier respnse team 5.00 Lw Medium Related t service center, difficult t separate respnsibilities. Resurce need will fall utside f OE and data recnciliatin. Data recnciliatin 3.25 Lw High Lng-term FTE need will fall with EDI imprvements. 834 Audit will need nging supprt, thugh requires in-depth system expertize (database level changes). Prductin EDI mnitring 0.75 Lw High Needs in-depth system expertize. Clsely related t develpment tasks. Resurce need will increase as mre carriers use mre EDI features. EDI regressin testing 0.25 Lw Lw Related t ther system develpment/ test functinality. Requires in-depth system expertize. Resurce need will fall ver time. 4

5 We will reduce the nging cst f the CCT ver time The verall demand fr CCT persnnel will nt vary much within 2015 We will transitin t a steadystate f apprximately 6 C4 and 9 CGI resurces Given the limited maturity f the EDI prcesses between C4 and the Carriers, we d nt feel it is apprpriate t utsurce the peratinal aspects f the EDI prcesses at this pint It wuld be apprpriate t cnsider this in

6 Dec (actual) Jan 2015 Feb Mar Apr May Jun Jul Aug Sep Oct Nv Dec Apprximate csting fr CCT thrugh 2015 External Optin Descriptin Internal FTE cst spend (net increase) Ttal cst Ntes 1. Transitin subset f CCT respnsibilities $400K $1.5M $1.9M This is the ptin described in this reprt t C4 2. CGI perates the CCT in its entirety n/a $2.3M $2.3M CGI wuld cntinue t wn carrier relatinship 3. Abandn the CCT n/a n/a n/a C4 wuld be unable t fulfill essential peratins Mnthly spend (ptin 1) Internal FTE cst 3,346 13,383 13,383 26,767 26,767 33,458 33,458 33,458 40,150 40,150 40,150 40,150 40,150 External spend (net increase) , , , , , , ,000 96,000 96,000 96, ,000 6

7 Wrking assumptins The same set f carriers will be cntinue t partner with C4 thrugh 2015 Carriers will be ready and able t test, bug fix and transitin interfaces t prductin t a fairly aggressive schedule CGI will cntinue t be cntracted t perate Carrier Respnse Team 7