RFI for Cloud-Based Community Care Referral, Authorization, Utilization Management and Coordination Systems
Location:
New Jersey, United States
Posted on:
Jan 28, 2026
Deadline:
Feb 2, 2026
Summary:
RFP for a cloud-based system to manage community care referrals, authorizations, and care coordination, including AI workflow and analytics features for New Jersey.
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Vendor needs to provide cloud–based community care referral, authorization, utilization management and coordination systems. • Develop and maintain interfaces required to integrate the HSRM solution with the enterprise, to include newly developed/modified/updated middleware, including Application Program Interfaces (API), and Vista patches. • AI to optimize workflows related to the tracking and documentation of care coordination activities, supporting timely decision making and improved care delivery. • Advanced analytics features that allow viewing claims data, medical documentation, care complexity, and risk factors. • Allow for flexibility of system to work alongside other AI solutions. • Utilize AI with machine learning to analyze medical records and flag cases for review. • Provide both manual and automated solutions with service–oriented architecture, flexible components, APIs, and configurable workflows. • Referral and auth data, emergency care notification system.
