Development and Implementation of a WfMS for IERs

The Pennsylvania Insurance Department (PID) is seeking a contractor to design, develop, test, and implement a Salesforce-based Workflow Management System (WfMS) for the Health Coverage Access, Administration, and Appeals (HCA3) Bureau. The system will automate and streamline the management of Independent External Reviews (IERs) for consumers and members of commercial insurance, Managed Care Organizations (MCOs), and Independent Review Organizations (IROs). The contractor will be responsible for system implementation, hosting, and ongoing maintenance and support. Key features of the project include: • Replacement of the current manual SharePoint and Excel-based process • Improvement of efficiency, security, scalability, and accuracy in handling IER cases • Agile development approach preferred, though hybrid or vendor-defined methodologies are acceptable • Electronic bid opening and submission through JAGGAER