Worker’s Compensation Claims Managed Care Service

The agency requires a vendor to provide worker's compensation claims managed care services for a one-year contract period. The requested scope includes managed care relating to network access, telephonic case management, on-site rehabilitation case services for catastrophic injury or indemnity assessment, and pharmacy services as needed. Network access features utilization review, first report of injury, re-pricing audits of provider bills, and 24-hour service access. Telephonic case management encompasses immediate case management activation, 24-hour physician referrals, case triage, return-to-work programs, treatment plan monitoring, case conferencing, pre-authorization of therapies and diagnostics, and continuous contact among employers, physicians, patients, and related parties. The buyer requires an onshore USA organization to perform the work offsite. The buyer accepts proposals for the budget and has not provided specific evaluation details or key dates in the text.