Description
UW Medicine is seeking a qualified vendor to provide end‑to‑end eligibility determination services for Washington State Medicaid (Apple Health), the Washington Health‑Benefit Exchange, and UW Medicine’s own Financial‑Assistance program. The contractor must integrate with UW Medicine’s Epic electronic health record system, process daily account files, and return eligibility decisions within statutory timeframes while maintaining strict HIPAA and state‑level security compliance. The work covers both primary and secondary placement of applications, includes out‑of‑state Medicaid processing (WY, AK, MT, OR, ID), and requires a staffed team of U.S.‑based personnel (no subcontracting of core functions). The contract term begins on October 1 2026 for an initial five‑year period with optional two‑year extensions.
• Process Medicaid, Exchange, and Financial‑Assistance applications via Epic work queues and daily file exchange.
• Provide trained navigators/certified application counselors, background‑check compliance, and 24/7 technical support.
• Deliver weekly/monthly reporting, KPI tracking, and maintain SOC 2/ISO 27001‑level security controls.
• Must have ≥ 5 years Epic experience, ability to handle out‑of‑state Medicaid, and U.S.‑based staff only.