The State of California is seeking a qualified vendor to provide a cloud-based electronic adjudication management modernization claims system, with a primary focus on workers' compensation claims management. This initiative is a key component of the broader modernization efforts for the Electronic Adjudication Management System (EAMS), serving as a complete replacement for the existing claims management system.

The solution must integrate seamlessly with external systems and the Google Cloud Platform (GCP) Enterprise Data Lake to consolidate operational data and deliver reliable analytics for enhanced claims management. Vendors should offer system configuration and customization capabilities as required, and the system should be delivered on a Platform as a Service (PaaS) or Software as a Service (SaaS) platform.

Key requirements include modern web and mobile interfaces to enhance the stakeholder experience, as well as improved operational efficiency through automation and intelligent, potentially AI-supported workflows. The solution must allow for case referrals to benefit recovery specialists using defined business rules, facilitate the review and authorization of bill payments within user authority levels, interface with bill review companies for efficient bill processing, and capture reasons for case closure upon status update.

This opportunity is suitable for vendors with expertise in cloud-based claims management solutions, system modernization, and experience integrating advanced analytics and automation into enterprise environments.