Cloud-Based Electronic Adjudication Management Modernization Claims System

Location:

California, USA

Posted on:

Jan 3, 2026

Deadline:

Mar 6, 2026

Summary:

California seeks a cloud-based claims management system to modernize electronic adjudication, integrate with GCP, and enhance automation and stakeholder experience.

(1) Vendor needs to provide cloud–based electronic adjudication management modernization claims system. • Provide a workers' compensation claims management system • Electronic adjudication management system (EAMS) modernization initiative and represents the claims management component of the overall EAMS modernization effort. • Integration with external systems and Google Cloud Platform (GCP) Enterprise Data Lake to integrate various operational data and deliver trusted analytics for claims management • System configuration and customization (as needed) • Enhance stakeholder experience with modern mobile and web interfaces • Improve operational efficiency through automation and intelligent workflows, possibly supported by artificial intelligence (AI) • The Claims solution will be built on a Platform as a Service (PaaS) / Software as a Service (SaaS) platform • The Claims solution will be a complete replacement of the functionality within the current claims management system. • System shall have the ability to refer a case to a benefit recovery specialist based on business rules. • Ability to review bills and authorize payments, subject to a user's authority. Ability to interface with bill review company for efficient processing of bills. • Ability to assign a closed status to a case and capture reason for closure. (2) All the questions must be submitted no later than Jan 16, 2026.

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Made with ❤️ in SF.

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