Workers’ Compensation Third Party Administration and Managed Care Cost Containment Services

The agency is seeking a vendor to provide workers' compensation third party administration and managed care cost containment services for its self-insured workers' compensation program. The selected partner will manage all new and existing claims, which includes reviewing medical bills, medical reports, and wage loss documentation prior to settlement negotiations. The scope of work requires the vendor to establish and maintain accurate claims reserves for all anticipated benefits and related cost exposures on each claim. To solve these administrative and medical challenges, the provider must review medical bills and treatment for causal relationships to claims and ensure the reasonableness of treatment prior to payment. The agency requires medical management, utilization review, and the maintenance of workers' compensation trust fund checking accounts. Additionally, the vendor must attend workers' compensation hearings and mediations as requested by the agency. The technical requirements include maintaining a computerized claims management system with an effective electronic data security system that features adequate access controls, integrity controls, and a continuity program for uninterrupted operations. Eligible bidders must be onshore organizations based in the United States. The performance of the work can occur either onsite or offsite, and bidders can submit their responses digitally via email or online. The agency is looking for proposals to determine the budget for this project. The resulting contract period will span three years. Bidders must submit all questions regarding this opportunity no later than June 12, 2026.