Vermont Department of Economic Development #03410-205-26

Physician Consulting Services for Vermont Medicaid Oversight

This opportunity from the Department of Vermont Health Access seeks physician consulting services to support Medicaid oversight and review. - Government Buyer: - Department of Vermont Health Access, Agency of Human Service, Vermont - Services Requested: - Medical oversight, prior authorization case review, and medical necessity determinations for Medicaid Managed Care - Consultative services for Surveillance and Utilization Review activities (federally mandated) - Services provided on an as-needed basis, not exceeding sixteen hours per week - Requirements: - Active physician licensure - Experience in Medicaid or managed care environments - No OEMs or product vendors are mentioned; the focus is exclusively on professional physician consulting services - Place of Performance: - Services delivered for Vermont Medicaid, with coordination between contractor and state officials

Description

The Agency of Human Service through the Department of Vermont Health Access is soliciting proposals to contract with an actively licensed Physician(s) to provide medical oversight, prior authorization case review, and medical necessity determinations in a Medicaid Managed Care environment. The contractor will provide consultative services on Surveillance and Utilization Review activities, federally mandated for all State Medicaid Managed Care Organizations. Services are to be provided on an as-needed basis, not to exceed sixteen hours per week, according to a mutually agreeable schedule.

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