Client: Centers for Medicare & Medicaid Services (CMS)
Industry: Healthcare & Regulatory Compliance

🚀 THE CHALLENGE

• 🎯 CMS lacked a standardized platform to measure hospital service quality for incentive-based government subsidies.
• 🎯 A new federal mandate required hospitals to submit quality data for compliance and funding eligibility.
• 🎯 Legacy manual, fragmented processes made data collection, validation, and reporting inefficient, impacting regulatory adherence.

Objective: Develop a comprehensive digital platform to streamline hospital quality data reporting, automate validation, and ensure compliance with government mandates.

👨‍💻 MY ROLE AS A PRODUCT OWNER / SCRUM MASTER

✔ Translated program objectives and key results (OKRs) into actionable product roadmaps.
✔ Defined epics, user stories, acceptance criteria, and UAT test cases to guide development.
✔ Led Agile ceremonies, including sprint planning, backlog refinement, reviews, and retrospectives.
✔ Acted as a liaison between CMS regulators and development teams, ensuring alignment on requirements.
✔ Implemented KPIs for tracking epic and story burndown, committed vs. completed work, and scope change trends.
✔ Drove execution while optimizing efficiency through data-driven decision-making.

🛠️ KEY FEATURES & SOLUTIONS

✅ Automated Quality Data Submission & Validation

• 📌 Standardized reporting framework → Ensured compliance with CMS regulations
• 📌 Automated data validation → Reduced manual entry errors & improved accuracy
• 📌 Dynamic quality scoring → Allowed real-time hospital performance tracking

📊 Regulatory Compliance & Performance Insights

• 📌 Integrated dashboards → Provided real-time hospital performance insights
• 📌 Custom reporting tools → Enabled hospitals to analyze & improve service quality
• 📌 Secure audit trails → Ensured transparency in subsidy calculations

💬 Stakeholder Collaboration & Data Exchange

• 📌 API integration with hospital EMRs → Streamlined data submission
• 📌 CMS-compliant reporting templates → Standardized quality benchmarks

📈 IMPACT & RESULTS

• 🚀 Enhanced Compliance → 100% alignment with CMS mandates for quality reporting
• 📊 Increased Hospital Participation → Improved ease of reporting led to greater adoption
• ⏳ 50% Faster Data Validation → Automated checks reduced processing time significantly
• 💰 Optimized CMS Incentives → Ensured accurate subsidy distribution based on quality metrics

🎯 KEY TAKEAWAYS

• 💡 Automation & Compliance → Reduced administrative burden & ensured regulatory adherence
• 📊 Data-Driven Insights → Improved hospital decision-making through real-time analytics
• 🔄 Seamless Workflow Integration → Enhanced collaboration between healthcare providers & CMS