Active SLED Opportunity · NEW YORK · GENESEE COUNTY
AI Summary
Genesee County seeks proposals for medical administration services for a self-funded health plan. The goal is to enhance plan management with cost-effective provider networks, claims administration, member services, and utilization management to ensure quality care and cost control.
The Client’s goal is to develop a long-term strategy that incorporates plan managementopportunities with access to the most appropriate and cost-effective provider networks. Pre-Bid Meeting Information: No Online Q&A: No Location Information: Department: Purchasing Address: 15 Main Street3rd FloorBatavia, New York14020 County: Genesee Other Details: • Provide a strategy incorporating network reimbursement/managed care capabilities intonew or existing programs• Deliver accurate, responsive, and timely claims payment• Provide effective and accurate member services• Provide timely, standard reporting and data file feeds to Gallagher and/or subcontractedvendors to assist the client in managing its Health PlanThe client is looking to select and implement a claims administrator with plan managementcapabilities for self-funded medical programs. It is not the Client’s intent to implement morerestrictive plan design features within their medical plans but to enhance the management of theseprograms through access to strong, quality-based networks. Therefore, this RFP will allow theClient to:• Select an administrator with a well-developed provider network to ensure employee accessto high quality care through network physicians, hospitals, and providers• Maintain effective pre-admission certification, concurrent review, and case managementprograms for all employees regardless of in or out-of-network access• Maintain freedom of choice for the employees to those providers best able to offer both thequality care and utilization controls necessary to meet benefits and cost objectives• Maintain effective utilization management in all areas Notes: Please fill out and return all Excel files along with your submission.
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
SamSearch Platform
AI-powered intelligence for the right opportunities, the right leads, and the right time.