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City-State, LLC is currently recruiting for a Technical Analyst- Financial Consultant for AECOM/NIOSH. TECHNICAL ANALYST – Financial Consultant (CLIN 0040) NIOSH – World Trade Center Health Program (WTCHP) Work Location - Off Site Full time (40 hours per week) Benefits Offered Travel Required Base Hourly Rate - $40.00 - $45.00 Start Date – January 4, 2021 (or ASAP) BACKGROUND On January 2, 2011, the President signed Public Law No. 111-347, the James Zadroga 9/11 Health and Compensation Act (“Zadroga Act”), providing a longer-term solution to care for the World Trade Center (WTC) responders and survivors. Title I of the Zadroga Act amended the Public Health Service Act to add Title XXXIII, which authorized the WTC Health Program as a federal health care program, within the Department of Health and Human Services, for eligible responders and survivors of the terrorist attacks of 9/11. See “James Zadroga 9/11 Health and Compensation Act of 2010,” Public Law 111-347, as amended by Public Law 114-113 (codified at 42 U.S.C. §§ 300mm –300mm-61). The Zadroga Act can be found at: https://www.govinfo.gov/content/pkg/PLAW-111publ347/pdf/PLAW-111publ347.pdf The Zadroga Act encompasses myriad responsibilities associated with the administration and performance needed to enroll, initially evaluate, medically monitor, and manage covered health conditions for eligible individuals through diagnostic and treatment services. Responsibilities include the construction of a comprehensive medical and pharmaceutical benefit program consistent with a limited care model (similar in constraints to a worker compensation model), while requiring the flexibility to engage with advocates and stakeholders. To align with legal requirements, the WTC Health Program promulgated regulations guiding program implementation and created member-based health benefit plans restricted to the conditions certified by the WTC Health Program Administrator for coverage. In addition, a new business processing component was developed to adjudicate and pay medical and pharmacy claims from enrolled providers for allowable services authorized by Clinical Centers of Excellence (CCEs) to manage the care of a restricted set of health conditions for eligible program members. Required administrative processes included procedures for appeals related to denials of program enrollment, health condition certification, or treatment bills. The WTC Health Program had to be operational within 6 months of the passage of the authorizing legislation - by July 1, 2011. In Spring 2011, the CDC awarded contracts to seven Clinical Centers of Excellence (as defined in subsection (b)(1)(A)) for the following tasks: ‘‘SEC. 3305. CLINICAL CENTERS OF EXCELLENCE AND DATA CENTERS. ‘‘(a) IN GENERAL. ‘‘(A) for the provision of monitoring and treatment benefits and initial health evaluation benefits under sub- title B; ‘‘(B) for the provision of outreach activities to individuals eligible for such monitoring and treatment benefits, for initial health evaluation benefits, and for follow up to individuals who are enrolled in the monitoring program; ‘‘(C) for the provision of counseling for benefits under subtitle B, with respect to WTC-related health conditions, for individuals eligible for such benefits; ‘‘(D) for the provision of counseling for benefits for WTC-related health conditions that may be available under workers’ compensation or other benefit programs for work-related injuries or illnesses, health insurance, disability insurance, or other insurance plans or through public or private social service agencies and assisting eligible individuals in applying for such benefits; ‘‘(E) for the provision of translational and interpretive services for program participants who are not English language proficient; and ‘‘(F) for the collection and reporting of data, including claims data, in accordance with section 3304. As of August 31, 2020, the WTC Health Program has 106,141 members enrolled, including 17,019 FDNY responders, 62,319 general responders and 26,803 survivors. However, not all of the members are active due to death, opting to not participate, or not having valid contact information. Clinical Centers of Excellence and the Nationwide Provider Network There are currently seven Clinical Centers of Excellence (CCEs) and one Nationwide Provider Network (NPN) that provide medical monitoring examinations, diagnosis, and treatment services for the WTC-related health conditions. One CCE serves the members affiliated with the Fire Department of the City of New York (FDNY) WTC Responders, five CCEs serve a General WTC Responder consortium, one CCE serves WTC Survivors, and the NPN serves enrolled members located elsewhere in the U.S. Treatment services include physician visits, test procedures, medical devices, pharmacy benefits, case management, care coordination, health education, and social benefits counseling. The CCEs and NPN work as a clinical consortium with cohort-specific standardized medical monitoring protocols, shared diagnostic and treatment guidelines and multiple opportunities for communication with WTC Health Program Staff and each other to calibrate medical and member benefits across practice sites. The CCEs and NPN are actively engaged with labor representatives and stakeholder members of the New York City community to discuss program policies and ensure awareness of emerging issues. SCOPE OF WORK The National Institute for Occupational Safety and Health (NIOSH),World Trade Center (WTC) Health Program is requesting a Contractor (Technical Advisor) to support the WTC Health Program’s responsibility to review, evaluate, and report on infrastructure costs related to Clinical Centers of Excellence (CCE) and the Nationwide Provider Network (NPN) contract administration in accordance with requirements of the James Zadroga Act. The Contractor will perform an assessment of CCE/NPN infrastructure costs in accordance with the James Zadroga Act. ‘‘(c) PAYMENT FOR INFRASTRUCTURE COSTS. ‘‘(1) IN GENERAL. The WTC Program Administrator shall reimburse a Clinical Center of Excellence for the fixed infrastructure costs of such Center in carrying out the activities described in subtitle B at a rate negotiated by the Administrator and such Centers. Such negotiated rate shall be fair and appropriate and take into account the number of enrolled WTC responders receiving services from such Center under this title. ‘‘(2) FIXED INFRASTRUCTURE COSTS. For purposes of paragraph (1), the term ‘fixed infrastructure costs’ means, with respect to a Clinical Center of Excellence, the costs incurred by such Center that are not otherwise reimbursable by the WTC Program Administrator under section 3312(c) for patient evaluation, monitoring, or treatment but which are needed to operate the WTC program such as the costs involved in outreach to participants or recruiting participants, data collection and analysis, social services for counseling patients on other available assistance outside the WTC program, and the development of treatment protocols. Such term does not include costs for new construction or other capital costs Infrastructure costs are intended to pay for: ‘‘(A) for the provision of monitoring and treatment benefits and initial health evaluation benefits under subtitle B; ‘‘(B) for the provision of outreach activities to individuals eligible for such monitoring and treatment benefits, for initial health evaluation benefits, and for followup to individuals who are enrolled in the monitoring program; ‘‘(C) for the provision of counseling for benefits under subtitle B, with respect to WTC- related health conditions, for individuals eligible for such benefits; ‘‘(D) for the provision of counseling for benefits for WTC-related health conditions that may be available under workers’ compensation or other benefit programs for work-related injuries or illnesses, health insurance, disability insurance, or other insurance plans or through public or private social service agencies and assisting eligible individuals in applying for such benefits; ‘‘(E) for the provision of translational and interpretive services for program participants who are not English language proficient; and ‘‘(F) for the collection and reporting of data, including claims data, in accordance with section 3304. The Contractor shall deliver a Project Management Plan (PMP) within 10 days after the technical kickoff meeting that lays out the Contractor’s approach, timeline, and tools to be used in the execution of this SOW. The tasks and deliverables are:A Work Plan to include the process, timeline, with proposed activities, milestones, and deliverables. The work plan will outline critical processes or guidelines proposed to assess and evaluate the infrastructure costs.The Contractor will perform CCE/NPN infrastructure internal control testing as it relates to industry health care internal controls evaluations which involves documenting any identified internal control deficiencies and infrastructure internal control improvement recommendations in an acceptable report format. Working papers and any other documentation must be maintained and contain enough information to ascertain the basis of the work performed and substantiate the conclusion(s) reached. These documents will become property of the CDC. The commencement of the CCE/NPN internal control testing will consist of an Entrance Conference with key members of the WTC Health Program.Specific tasks in support of this SOW include: a. Identify, gather, inspect, and validate supporting documents related to CCE/NPN infrastructure costs and compare the contents to contractual requirements. b. Perform initial walkthrough audits, observations, and activities such as document reviews, stakeholder interviews, information collection, and other preliminary assessment activities. c. Build financial models and analytical reports by collecting, monitoring, and studying d
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