Common use of Data Compliance Manager Clause in Contracts

Data Compliance Manager. The Contractor must employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. Pharmacy Director – The Contractor must employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays program who is responsible for the representation of members’ interests including input in policy development, planning, and decision-making. Member Advocate/Non-Discrimination Coordinator shall have knowledge and experience about HCBS consumer concerns related to HCBS providers and

Data Compliance Manager. The Contractor must shall employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays Hoosier Healthwise data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. The Data Compliance Manager shall manage data quality, change management and data exchanges with FSSA, OMPP or its designee(s). The Data Compliance Manager shall be responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA and OMPP as defined by the State. The Data Compliance Manager shall coordinate with the State to implement data exchange requirements. Pharmacy Director – The Contractor must shall employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants3.4. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays Hoosier Healthwise program who is responsible for the representation of members’ interests including input in policy development, planning, planning and decision-decision- making. The Member Advocate/Non-Discrimination Coordinator Advocate shall have knowledge be responsible for development and experience about HCBS consumer concerns related to HCBS providers andoversight of the Member Advisory Committee. This individual shall also be

Data Compliance Manager. The Contractor must shall employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays Hoosier Healthwise data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. The Data Compliance Manager shall manage data quality, change management and data exchanges with FSSA, OMPP or its designee(s). The Data Compliance Manager shall be responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA and OMPP as defined by the State. The Data Compliance Manager shall coordinate with the State to implement data exchange requirements. Pharmacy Director – The Contractor must shall employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants3.4. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays Hoosier Healthwise pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays Hoosier Healthwise program who is responsible for the representation of members’ interests including input in policy development, planning, planning and decision-making. The Member Advocate/Non-Advocate shall be responsible for development and oversight of the Member Advisory Committee. This individual shall also be responsible for the Contractor’s compliance with federal and state civil rights laws, regulations, rules and policies, including but not limited to, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) and the Age Discrimination Coordinator shall have knowledge and experience about HCBS consumer concerns related to HCBS providers andAct.

Data Compliance Manager. The Contractor must shall employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays Hoosier Healthwise data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. The Data Compliance Manager shall manage data quality, change management and data exchanges with FSSA, OMPP or its designee(s). The Data Compliance Manager shall be responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA and OMPP as defined by the State. The Data Compliance Manager shall coordinate with the State to implement data exchange requirements. Pharmacy Director – The Contractor must shall employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants3.4. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor Contrac tor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays Hoosier Healthwise pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays Hoosier Healthwise program who is responsible for the representation of members’ interests including input in policy development, planning, planning and decision-making. The Member Advocate/Non-Discrimination Coordinator Advocate shall have knowledge be responsible for development and experience about HCBS consumer concerns related to HCBS providers andoversight of the Member Advisory Committee. This individual shall also be responsible for the Contractor’s compliance with federal and state civil rights laws, regulations, rules and policies, including but not limited to, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) and the Age

Data Compliance Manager. The Contractor must shall employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays Hoosier Healthwise data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. The Data Compliance Manager shall manage data quality, change management and data exchanges with FSSA, OMPP or its designee(s). The Data Compliance Manager shall be responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA and OMPP as defined by the State. The Data Compliance Manager shall coordinate with the State to implement data exchange requirements. Pharmacy Director – The Contractor must shall employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants3.4. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays Hoosier Healthwise pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays Hoosier Healthwise program who is responsible for the representation of members’ interests including input in policy development, planning, planning and decision-making. The Member Advocate/Non-Discrimination Coordinator Advocate shall have knowledge be responsible for development and experience about HCBS consumer concerns related to HCBS providers andoversight of the Member Advisory Committee. This individual shall also be responsible for the Contrac tor’s compliance with federal and state civil rights laws, regulations, rules and policies, including but not limited to, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) and the Age

Data Compliance Manager. The Contractor must shall employ a Data Compliance Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Data Compliance Manager will provide oversight to ensure the Contractor’s PathWays Hoosier Healthwise data conform to FSSA and OMPP data standards and policies. The Data Compliance Manager must have extensive experience in managing data quality and data exchange processes, including data integration and data verification. The Data Compliance Manager must also be knowledgeable in health care data and health care data exchange standards. The Data Compliance Manager shall manage data quality, change management and data exchanges with FSSA, OMPP or its designee(s). The Data Compliance Manager shall be responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA and OMPP as defined by the State. The Data Compliance Manager shall coordinate with the State to implement data exchange requirements. Pharmacy Director – The Contractor must shall employ a Pharmacy Director who is an Indiana licensed pharmacist dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Pharmacy Director shall oversee all pharmacy benefits under this Contract as outlined in Section 3.3 and have knowledge and experience in geriatric pharmacy as it relates to HCBS participants3.4. This individual shall represent the Contractor at all meetings of the State’s Drug Utilization Review (DUR) Board meetings and the Mental Health Quality Assurance Advisory Committee (MHQAC). If the Contractor subcontracts with a Pharmacy Benefits Manager (PBM) for its PathWays Hoosier Healthwise pharmaceutical services, the Pharmacy Director shall be responsible for oversight and Contract compliance of the PBM, including pharmacy audits, as well as any other audits or responses. Transition Coordinator – The Contractor must employ a Transition Coordinator located in Indiana dedicated full-time to the PathWays program who is a health care professional or who possesses the appropriate education and experience and is supported by a health care professional. The Transition Coordinator will oversee and coordinate the initial and ongoing member transitions in and out of the various Indiana Medicaid programs, the Contractor’s enrollment, and among care settings. The Transition Coordinator shall work closely with the transition coordination staff, providers and the State to obtain, utilize and share member transfer information to safeguard successful, timely, and orderly transitions. The Transition Coordinator shall have prior experience in LTSS or with the program population. Member Advocate/Non-Discrimination Coordinator – The Contractor must employ a Member Advocate/Non-Discrimination Coordinator dedicated full-time to the PathWays Hoosier Healthwise program who is responsible for the representation of members’ interests including input in policy development, planning, planning and decision-making. The Member Advocate/Non-Advocate shall be responsible for development and oversight of the Member Advisory Committee. This individual shall also be responsible for the Contractor’s compliance with federal and state civil rights laws, regulations, rules and policies, including but not limited to, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) and the Age Discrimination Coordinator shall have knowledge and experience about HCBS consumer concerns related to HCBS providers andAct.