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**Please Note** This opportunity was not issued by a DAS procurement program.
Please refer to the opportunity information in the attached document.
External Quality Review Services for Medicaid Managed Care
The Ohio Department of Job and Family Services (ODJFS) releases this Request for Proposals (RFP) on behalf of the Ohio Office of Medical Assistance (OMA) for the purpose of obtaining a qualified vendor to perform an independent external quality review that consists of mandatory and optional activities (e.g., administrative compliance assessments, validation of performance improvement activities, encounter data validation studies, and consumer satisfaction surveys) for Medicaid health plans that are contracted with the state Medicaid agency. Information obtained from the independent external quality review is used to assess the quality, accessibility and timeliness of services that Medicaid health plans provide to their enrolled members. The results of the annual independent external quality review are also used to ensure OMA’s compliance with federal requirements to arrange for an external, independent evaluation of contracted health plans and to adhere with associated reporting requirements specified in 42 CFR Part 438 Subpart E. The selected vendor will also provide OMA and its contracted health plans with technical assistance, national expertise, and cutting-edge technological support to improve the overall performance of the managed care delivery system.
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