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CC-1720 - USA (Oklahoma) - RFI for Customer Contact Center Solution - Deadline June 19,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: CC-1720

Government Authority located in Oklahoma; USA based organization looking for expert vendor for customer contact center solution.

[A] Budget: Looking for proposal

[B] Scope of Service:

Vendor needs to provide customer contact center solution for medical benefits to certain low-income individuals who have inadequate or no health insurance coverage including to temporary changes in call volume (e.g. Open Enrollment periods) or address support models in the event of a pandemic or natural disaster, including the capability to support staff working remotely in a decentralized environment.
- call centers at OHCA include:
- Provider Enrollment
- Provider Services
- Medical Authorization Unit
- Member Services
- Pharmacy Services
- Online enrollment questions from members
- Current Staffing and Call Volume: - The current call center supports more than 800,000 calls annually with the capabilities described in more detail below. The current call center staffing consists of 250 agents that provide Tier 1 and Tier 2 support for the member, provider and pharmacy services, along with third party liability calls.
- Medicaid Management Information System: - Record ID, Authorized Services, Eligibility Status, Start, effective date and end dates of service, Coverage Priority, Personally Identifiable Information (PII) such as SSN and Medicaid number, Dependent PII, Demographic information, Guardianship information, Consent information, Predicted outcomes for the care/case management program (e.g., Emergency Room visits, pharmacy costs, etc.), Call tracking notes and agent comments, Attachments.
- Support exchange of health care and clinical information, preferably via Application Programming Interfaces (APIs), with interstate agencies and providers;
- Incorporate industry standards and other nationally recognized standards for interoperability;
- Utilize service-oriented, cloud-based platforms;
- Establish service level agreements and Key Performance Indicators (KPIs);
- Utilize a web-based person-centric system for outreach to providers, applicants and members;
- Incorporate information from Health Information Exchange networks, where appropriate;
- Utilize standardized business rules definitions via a business rules engine;
- Use automated services and messages in highly automated processing of healthcare and eligibility transactions throughout the state; and
- Produce audit trails for information within the system.
- For more information describe in documents.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Friday, 19 June, 2020

Category : Call Center and Answering, Medical Billing and Coding, Software, System and Application

Country : USA

State : Oklahoma

RFP Expired

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