Medicaid Management Information System (MMIS) Replacement
The Management-of and Execution-of MMIS Replacement Initiatives
The US Department of Health and Human Services (HHS) Center for Medicare and Medicaid Services (CMS) oversees and funds the modernization of Medicaid Management Information Systems in many US states and territories.
Charles Goolsby has extensive experience in developing and managing the large-scale solution and regulatory requirements data sets that support state MMIS modernization initiatives.
Charles has actively participated in the business analysis, technical analysis, product management, and IT project management roles for the following types of MMIS modular replacement initiatives:
MMIS Business Modules:
- Eligibility and Enrollment
- Provider Enrollment/Provider Management
- Pharmacy Benefits Management
- Care Management
System Integration / Service Oriented Architecture (SOA):
- Enterprise Service Bus (ESB)
- Enterprise Document Management (EDM)
- Master Data Management (MDM)
- Business Rule Engine (BRE) / Policy Automation
Charles has extensive experience in the following MMIS frameworks:
- Medicaid Information Technology Architecture (MITA 3.0)
- MITA 3.0 Business Process Areas and Business Processes
- Medicaid Enterprise Certification Toolkit (MECT ver. 2.3)
- Medicaid Outcomes Based Certification (OBC)
- Medicaid Provider Enrollment Compendium (MPEC)
- US Code of Federal Regulations (CFR) applicable MMIS