Overall Approach Clause Samples

Overall Approach. Supplier will support interfaces that integrate third party products and services as of the Effective Date. Subject to Change Control, Supplier will additionally support modifications to existing interfaces as well as support for new interfaces as needed to support the Services and as requested by Health Net. Supplier will coordinate directly with third parties as necessary to support the Integration Services. Integration Services categories are anticipated to be: • Electronic Data interface (EDI) scheduled at regular intervals, it will be used to send and receive data from third party vendors and will be scheduled at regular intervals. Such interfaces will use proprietary framework, • Third-party integration in real time (▇▇▇▇▇▇▇, for example) typically used for claims processing or pricing, • Integration aligned to processing, (iHealth, for example).

Overall Approach. Cross Functional User Acceptance Testing includes those functions associated with planning, coordinating, and executing testing activities related to the Services with appropriate members of the Health Net retained organization. User Acceptance Testing methods and procedures are outlined in Schedule J (Project Framework).

Overall Approach. Supplier will follow industry standard human resource practices to manage service related Training Services as performed for the Services. The Training Model will be set up as shown in the diagram below: (a) Skill Gap Assessment: • All resources will be mapped to the skills for their level and the next level for their role, • Supplier will perform personnel competencies verification, • The results will reflect, by resource, the gap in skill for the resource’s current job level and the next level, • Supplier will review the audit findings for gaps in training material or policy and procedure and update accordingly, • Supplier will also assess the gaps in the Supplier training staff capabilities. (b) Develop training material: • Training requirements will be divided into process and soft skills, • For domain training, Healthcare Boot Camp Training will be used to induct new team members for Healthcare specific processes, • For process training, the desktop procedures created by operation teams will be reviewed to ensure they are as per defined procedures & formats and all new changes & updates are being documented, • Training curriculum and material to bridge the gap for the current level and ‘up-skilling’ will be identified for every resource including on Regulatory, Compliance, HIPAA Privacy and Security related aspects, • Training curriculum and material will be created for gaps identified in audits, • Other than process training, gaps in soft skills, e.g., communication, leadership, etc. will be addressed by customizing the standard Supplier training programs. (c) Training delivery: • Training sessions will be organized for resources that have on boarded or per their individual training plan, • The Policies and Procedures will be used in the initial and refresher training sessions and will also be used to serve as reference material for resources on the job, • Training calendar will be created and updated related to process training and soft skills development, • Training staff will be trained using internal and external resources, • Training reports will be published to include attendance, course completion, etc., • Training will be provided on researching, responding to, tracking and reporting privacy related incidents. (d) Training Effectiveness: • New Supplier Personnel supporting the Services will undergo and successfully complete the boot camp training, • Training technology, methodologies, courses, content and approach will be reviewed and updated...

Overall Approach. The portfolio of Managed Third Party Contracts is as set forth in Schedule A and will be segmented into either BPaaS scope with the intent to re-contract before Phase 3 (where applicable) or Non-BPaaS. Whether Supplier will subsequently re-contract directly with vendor will be guided by the terms as outlined in Schedule O (Health Net Provided Resources). Some contracts that are extremely large such as IBM and AT&T will be managed by a dedicated team and have specific financial objectives associated with oversight and optimization as called out in Schedule C (Charges). Managed Third Party Contracts is subject to the terms relating to the Use of Health Net Resources as outlined in Section 11.2(d) of the Terms and Conditions. Managed Third Party Contracts will be managed by Supplier beginning on the Services Commencement Date. Any third party contracts that are procured by the Supplier prior to the Service Commencement Date will be managed from the effective date of that agreement. Contracts that are shared across BPaaS and non-BPaaS will either be split or agreed with Health Net to remain in the appropriate category for management as a combined entity with the intent of greater cost savings and management efficiency. The remaining Non-BPaaS managed contracts will be under the governance and control of Health Net. Supplier will help Health Net look for opportunities to optimize and reduce costs. Supplier will manage third party services to help ensure BPaaS SLAs will be met. Supplier will focus on establishing a relationship with Health Net and bilateral responsibilities with qualified third-party service providers and monitoring the service delivery to verify and ensure adherence to SLAs, and underpinning contracts. This will be achieved by identifying and categorizing services, identifying and mitigating risk and monitoring and measuring performance

Overall Approach. Supplier will assign a Compliance Officer to oversee and manage the Supplier Compliance Program for Services provided under this Agreement. The Supplier Compliance Officer will manage and oversee all aspects of Compliance for delivery of the Services. The Supplier Compliance Officer will report, in a timely fashion and in conformance with timeframes established by Health Net, incidents of suspected or identified noncompliance to Health Net’s Compliance Officer. Supplier’s Compliance Officer will provide information as required by Health Net’s Compliance Officer to ensure that Health Net’s Boards of Directors are appropriately apprised of compliance issues and risks. Supplier will develop a comprehensive Compliance Plan that will be a written document describing the specific manner in which the Compliance Program elements will meet the standards for all lines of business. Specific procedures to execute the functions required of the Compliance Plan will be documented as part of the Procedures Manual. Supplier’s Compliance Plan will be reviewed and revised at least annually and align with Health Net’s compliance plans for each line of business. If there are changes in regulatory requirements or changes to Health Net and Supplier business processes, the Compliance Plan will be modified throughout the year to reflect current Laws and business practices serving as the means of documentation of record and approach to be in compliance. The Compliance Plan will also include ongoing risk assessment and issue event response procedures so the program will respond in near real time to regulatory issues that arise, and have the capability to deploy appropriate resources where and when needed. The Compliance Plan will include processes for assessing the effectiveness of the Compliance Program, through the use of effective, two-way communications self-audit, feedback mechanisms, and reporting metrics. Supplier will be accountable and have responsibility for ensuring compliance of all Services as of the BPaaS Services Commencement Date. Health Net will be the responsible party for performing the final interpretation of Compliance rules as they impact BPaaS operations and will provide specific requirements to Supplier’s services teams to implement within the BPaaS scope. ▇▇▇▇▇▇ ▇▇▇▇▇ ▇, ▇▇▇▇▇▇▇▇ will support Health Net’s compliance activities and become familiar with Health Net’s compliance processes. Supplier will build controls or leverage existing controls in all operati...

Overall Approach. In broad terms, the approach adopted for the Evaluation of the Quality of the Objectives and Indicators of the Management Plan of DG Enterprise & Industry involved three phases: • Phase 1: Preparatory Tasks – set up meetings and various preparatory tasks including an initial survey of relevant documents, review of current objectives and indicators and the preparation of research tools, leading to an inception report; • Phase 2: Review of objectives & indicators, interviews and analysis – continuing desk research and an interview programme with Directors and other officials from DG ENTR. The submission of First Findings and Recommendations Report; • Phase 3: Further analysis and Final Report –further analysis, especially in the light of comments made by the Steering Group and from responses to the circulated draft. A Final Report was then prepared, plus an operational guidance document that can be used by desk officers for establishing and monitoring indicators. This section sets out how the investigation proceeded. It covers the following issues : • Further clarification of the nature of the Management Plan and its component elements. • The conduct of the interview programme and its results • The comparison with other Management Plans (mainly those of other DGs) • The conclusions of the analysis of the MP against SMART and RACER criteria and other background material. The evidence is set out that acts as the basis for the main conclusions and the recommendations the final sections.

Overall Approach. Supplier will manage the Collection of Funds consistent with each of the Services in all the in-scope Towers. Supplier will redirect such funds to the appropriate lock box in a timely manner when funds are received outside of the standard process.

Overall Approach. In addition to continuous improvement to the Services the Supplier will develop and annually update an Innovation Plan that will be the basis for material improvements to the Services over the Term. Development of the Innovation Plan will involve an assessment of market trends, challenges, and capabilities in the market space, including market advancements, changing and evolving legislative drivers, competitive capabilities, as well as existing and emerging opportunities. The Innovation Plan will include benchmarks within the industry that can be used to measure efficiency and maturity of the Services. The Innovation Plan will include targeted improvements, priorities, and recommendations that can be evaluated for inclusion in: • The Road Map and/or, • Discretionary projects, • Non-Discretionary projects with the goal of capitalizing on opportunities to continually mature and innovate the Services.

Overall Approach. An awarding organisation must explain its overall approach to Centre Assessment Standards Scrutiny and how its approach (including where it uses Moderation) will ensure the standards and validity of its qualifications are maintained where assessments are marked by Centres. It must explain why its approach is appropriate for its qualifications in view of any risks that it has identified as arising from Centre marking and how it will ensure that its qualifications are manageable for Centres delivering them. It must explain how it will ensure, through its arrangements with a Centre that it is able to comply with its Conditions of Recognition in respect of assessments for that qualification.