Web-Based Utilization Management Review System

The buyer requires a vendor to provide a web-based utilization management review system for a five-year contract period. The requested scope includes supplying a software platform that supports data collection, defines admission criteria and length-of-stay standards, and provides web access for various care types, case management, and transitions of care. The platform must feature intuitive workflows for prospective, concurrent, and retrospective reviews, enabling care managers to enter diagnosis and procedure codes and document decisions using clinical evidence. Additionally, the software must incorporate evidence-based tools for readmission risk assessment, automated alerts, and utilization review reporting. To be eligible, the bidder must be a USA organization. The vendor will perform all work offsite. Bidders must submit proposals digitally via email or online, as the buyer is currently looking for proposal pricing to establish the budget.