State of Missouri Seeks Medical Care Utilization Review Services
RFP Category: Consulting – Strategic/Financial
RFP Sponsor: State of Missouri – Office of Administration
Due Date: 10-16-2014
Contact Name: Laura Ortmeyer
Contact E-Mail: firstname.lastname@example.org
Contact Phone: 573-751-4579
Description: The State of Missouri is seeking competitive, sealed proposals, for the provision of Medical Care Utilization Review Services. The services will be for the Department of Insurance, Financial Institutions, and Professional Registration.
Applicable contractors must provide a Medical Director who shall be available for discussion within the state agency regarding specific medical cases under review. This Medical Director shall hold a non-restricted medical license in the State of the United States
The contractor’s services shall primarily pertain to the state’s external review process; however, the services may also include providing medical expertise on health related issues.
The contractor shall have experience with utilization review activities and shall be certified, at the time of proposal submission, by the state agency as a utilization review agent, pursuant to sections 374.500 through 374.515, RSMo.
The contractor shall be accredited or certified by a nationally recognized private accrediting organization for Health Utilization Management, Independent Review Organization, or other accreditation or certification for services that are substantially similar to the services provided under the contract.