Prior Authorization Solution and Professional Review Services
Location:
Jefferson, Missouri, United States
Posted on:
Deadline:
Summary:
Missouri is seeking a vendor for a five-year contract to deliver a prior authorization solution and related professional review services for a government agency in Jefferson.
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The state government authority in Jefferson, Missouri is seeking a vendor to provide a comprehensive prior authorization solution and professional review services. Key responsibilities include supplying a data administrator with the appropriate combination of skills and experience to manage solution data, as well as a fully dedicated operations manager during training, launch, and ongoing operations.
The selected vendor must also provide a solution architect with prior experience designing, developing, and overseeing the architecture of a prior authorization solution for either another state Medicaid agency or a similarly sized health claims processing organization. A privacy and security officer will be responsible for overseeing all solution-related privacy and security matters. The database administrator is required to hold a bachelor's degree in information technology or a closely related field. An account manager must maintain consistent, proactive communication with the state agency, including regular monthly status reports, to ensure transparency and strong customer service.
The operations manager is expected to be fully committed throughout the contract transition period. The contract term will span five years, and a pre-bid teleconference will be conducted on March 31, 2026.
Best-fit vendors:
• Experience delivering prior authorization solutions for state Medicaid programs or similar health claims processing organizations
• Team with skilled data and database administrators, solution architects, and privacy/security officers
• Strong customer service and account management practices for government clients
• Experience coordinating large-scale IT system transitions and ongoing support
• Track record of compliance with privacy and security standards in healthcare
