What We Do Best

Our Approach

With a commitment to a three-step approach, we create innovation through a proven people, process, and technology strategy.

PEOPLE

With a people-centric mission, J29 recruits technical and industry leaders that bring valuable expertise to the Public Sector programs that we support. By ensuring that our teams are composed of the highest subject matter experts, J29 ensures that we are able to bring innovation to agencies.
 

PROCESS

To be effective in bringing innovation, it's critical for our team to understand the process flows of the programs we support.

J29 tailors a process that allows agency programs to re-distribute labor to other demands within their business unit, using proven program management principles.

TECH

Through an age of transformation our team is passionate in implementing technology to support, not replace, our employees and government programs. Our team has system integration partners, as well as analytics teams that allow us to stay aligned to agency technical strategies.
 

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Creating "Hope For the Future" Through Innovation and Delivery Areas

 
Health, Human-Service Claims Analytics

J29 brings healthcare experience under the competencies of data analytics, claims analysis, interoperability platforms, medical case reviews, and ADT feed architecture with direct experience to Federal, State, and Regional governments.

QUALITY

Through the processing of claims, it's critical to have high quality through intake, review, development, QA, and determinations. Our quality is graded on a 45-point process flow, with an average performance score of:

J29's QUALITY PERFORMANCE AVERAGE

99.65%

INNOVATION

J29 focuses on innovating labor-intensive processes of reviewing, auditing, and making determinations on Medicare and Medicaid claims. Labor-intensive processes are bound to have human errors, often times resulting in improper payments to beneficiaries.

 

AI will allow our clinically-experienced case reviewers to better re-allocate their time from labor tasks to better using their subject matter expertise on the medical determinations. You can read more about our innovative strategy in the HHS claims space, here.  

EXPERIENCE

J29 and its staff brings a combined 20+ years of experience reviewing claims, including; 

  • Risk Adjustment Data Validation (RADV)

  • Medicare Part A

  • Medicare Part B

  • Medicare Part D

  • Medicare Set-Aside (MSA)

  • Medicare Secondary Payer (MSP)

  • 'No Surprises Act'

  • Through this experience, we hold industry certifications such as: MSCC, CCM, ACM, CCMP, CPDM, RN, LPN, CMGT-BC.

CODING

We cover three main types of coding, such as:

  • International Classification of Diseases (ICD) 9/10 Codes

  • Current Procedure Terminology Codes (CPT)

  • Healthcare Common Procedure Coding System (HCPS)

Our coding expertise focuses around J29 case reviewers specializing on pricing allocations for Medicare as a primary, and in certain cases, secondary payer. 

Data Management and Analytics

Data is now the most valuable asset on the planet. We provide comprehensive management services to enable agencies to make data-driven decisions. 

ANALYTICS

We work with open source relational databases to let Public Sector data sets to drive agency strategies.

J29 has performed in four main types of analytics for government agencies - descriptive, diagnostic, predictive, and prescriptive analysis.

DATA GOVERNANCE

We work with large, and small scale agencies to manage the usability, integrity, and security of data in enterprise systems. Our experience is based around domain expertise for data standards and policies for data usage expectations. 

VISUALIZATION

High-quality analysis allows us to make accurate strategies and decisions from data sets. Clean and secure data enables J29 to create actionable scorecards, dashboards, and stories tailored to agency demands. 

J29 has supported custom dashboards on Maryland's Child, Juvenile, and Adult Management System (CJAMS) application.

HEALTHCARE

Our team is committed to the recently published strategic goals by the Department of Health and Human Services (HHS). 

These four pillars are focused around the improvement of care through health data, using data ecosystems to accelerate research, and eliminating fraud, waste, and abuse through attentive analytics. 

 
Project Management Office (PMO) Support

Project and program management are critical for transformation, program failure overhaul, budgeting, and ensuring agency stakeholder missions are being enforced. 

METHODOLOGY

Our program, and project, managers hold decades of Agile successes while maintaining a constant and ongoing pace for project success. J29 aids agencies in cultural transformations from waterfall to agile programs, and ensuring stakeholder goals are aligned to our delivery.
 

PROJECT MANAGEMENT

Our domain experts hold valued certifications in the leading titles:

  • PMP (Project Management Institute)

  • CAPM (Project Management Institute)

  • Certified Scrum Master (CSM)

  • Agile Certified Practitioner (PMI-ACP)

  • CompTIA Project+ Certification

  • Professional in Project Management (PPM)

PORTFOLIO OVERSIGHT

Throughout our teams' key principles on Agile program success include stakeholder buy-in, agency satisfaction, sustainable development, readiness to change environments and show agility, and decreasing objective misses.

PROCESS

Ensuring delivery through Agile methods is the upmost priority. 

 

Scrum delivery allows for our development life cycles to conduct sprints, story reviews, scrum master oversight management, and priority assessments that increase productivity, lower costs, and eliminate life cycle conflicts.

 
Task Order Staff Augmentation

J29 has proven to be able to scale to mission-critical demand, through staff augmentation.

DELIVERY

Our recruiting team delivers on our staff augmentation areas by being able to:

 

  • Quickly scale up (meeting demands of quick task orders)

  • Having a revolving qualified pipeline

  • Meeting budget requirements of State and Federal agencies. 

EXECUTION

Once we have provide a team for a respective agency, we work with stakeholders on delivery reports, retention plans, and continuous education for resources. 

In order to ensure we are executing, our pipeline development does not stop when resources are augmented. Our qualified pipeline allows us to continue to execute in the event of a sudden resource departure. 

Continuous, Task Order Augmentation

Maintain pool of pre-   

qualified candidates     

- repeat cycle      

Identify agency missions

  and pain-points

Engage on sourcing strategy, recruit domain experts

         Following candidate         hire, process through         orientation and training    (inc. retention program

Replace as required    (unexpected   

departure, lower    performance) 

 
Medical Determinations and Reviews

Effective determinations and independent reviews enable our team to leverage data to improve patient outcomes in the healthcare space.

INDEPENDENT / EXTERNAL

J29 specializes in providing independent or external medical reviews, which handle submissions from beneficiaries, payers, providers, legal representation, care givers, and more. 

Through the reviewing process, our team uses expertise on treatment, surgeries, pricing, primary care, prescriptions, and additional medical-related costs. 

APPEALS

Aside from independent reviews, J29 has provided appeals determinations where a disagreement has been reached and we work to mitigate the reasoning. 

Through the appeals process comes varying local, State, and Federal laws that our team takes into consideration when making appeal determinations. 

 
Healthcare IT Subject Matter Expertise

J29 brings healthcare experience under the competencies of data analytics, claims analysis, interoperability platforms, medical case reviews, and ADT feed architecture with direct experience to Federal, State, and Regional governments.

INTEROPERABILITY

J29's team has worked in this domain with expertise on HIE creations from scratch, ADT feeds, human-service cloud based repositories that connect with EHR's, HIE's, and State department systems.

ARTIFICIAL INTELLIGENCE

J29 subject matter experts have worked with non-profits, State, and Federal teams to developing innovation to be used in those domains. From process flows, to architecture governance, we combine technology with deep clinical knowledge and expertise in community networks.  

 
Support Desk Services

The use of an effective support desk allows agencies to continue to enable their staff to leverage technology to improve their business decisions.

ITSM PLATFORMS

J29 provides live call-center, on-site help desk support, and ITSM integrations.

 

The use of ITSM platforms allows us to have a Tier-0 of support, that automates typical help desk tickets through manuals and common problems. 

RELIABILITY

Our analytics team works with agency stakeholder and help desk program managers to assess common problems and determine how they can be fixed. 

We have a Tier 0 - Tier 4 help desk process to support all technical problems. Through large and small agencies, J29 provides 24/7 support.