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SW-26839 - USA (Pennsylvania) - Medicaid Management Information System 2020 Platform - Deadline October 16,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: SW-26839

Government authority located in Pennsylvania; USA based organization looking for expert vendor for medicaid management information system 2020 platform.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide medicaid management information system 2020 platform to modular enterprise-wide system providing automated support for the Department’s programs in both the fee-for-service (“FFS”) and managed care organization (“MCO”) delivery systems, various waiver programs, the Low-Income Energy Assistance Program (“LIHEAP”), and the Medical Assistance Provider Incentive Repository (“MAPIR”).
- The Department has worked with CMS to develop a plan to transition from the current monolithic system to a modular solution.
- This may include commercial off-the-shelf (“COTS”) or modified off-the-shelf (“MOTS”) products or both on premise (Commonwealth hosted) or remotely hosted, newly procured components, Software as a Service (“SaaS”), and legacy applications that utilize custom code.
- Services required include the development, training, testing, implementation, operations and maintenance of each module, all consistent with the most current industry standards and practices, Department and CMS requirements, guidelines, standards, and procedures for the MMIS 2020
Platform.
- Lot 1: PA additional business objectives include:
1. Provide a web-enabled, flexible solution that supports automated PA and program exception (“PE”) enterprise Case Management processes and is compliant with Department and Federal requirements and policies. The solution must allow access for 500 to 1,000 concurrent users. The solution must support the Department’s numerous programs, benefit plans, and service types;
2. Provide a configurable automated rules engine for the PA Module that allows the Department to easily define and modify all business rules;
3. Allow several options for requesting, modifying and viewing PA/PEs, including mobile technologies, via the MMIS 2020 Platform provider portal, and by paper and telephone;
4. Provide the ability for users to perform PA/PE and Case Management transactions online and in real time;
5. Provide a solution that is innovative and offers a wide range of capabilities including benefit exception processing, flexible PA/PE pricing, a field to provide file notes, a PA/PE mass update process, and quality audits;
6. Provide a PA/PE Appeals process that supports appeals, telecommunications, peer-to-peer conferences, automated case tracking, and appeals reporting;
7. Provide a configurable automated workflow using business rules to control workflow sequence and include capabilities such as fax to desktop, alerts, and record locking;
8. Provide standardized and ad-hoc reporting on PA/PE and Case Management functions;
Lot 2: OBM additional business objectives include:
1. Supply mailroom services to distribute electronic and paper communications to MMIS 2020 stakeholders including providers, MCOs and beneficiaries, for the MMIS 2020 Platform;
2. Integrate with the DH to accept and process batch jobs to send electronic and paper communications;
3. Provide a web-based document storage and retrieval system accessible to authorized users;
4. Supply mailroom paper products;
5. Provide transportation of all outbound mail to the United States Postal Service (“USPS”), UPS and FedEx;
6. Provide flexible, dynamic, online, letter generation capabilities;
7. Provide electronic methods including email and text messages for delivering communications;
8. Provide traceability and reconciliation capabilities for all mailroom activities;
9. Implement mailroom best practices to consistently achieve.

[C] Eligibility:

Onshore (USA Only)

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Wednesday, 16 October, 2019

Category : Software, System and Application

Country : USA

State : Pennsylvania

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