Description
The Alaska Department of Health is seeking a software and services vendor to implement and support a modern Service Authorization (SA) program. The successful offeror will integrate their standalone SA solution module with the existing Medicaid Management Information System (MMIS) using a wide range of interfaces. The scope of work includes implementation, configuration, testing, maintenance, and hosting of a Service Authorization solution, as well as Service Authorization Support Services, including service authorization decisioning, clinical reviews, and development of clinical criteria. The state anticipates adding future scope to include enhanced Utilization Management support services.
• Implementation of a Service Authorization solution
• Configuration and testing of the solution
• Maintenance and hosting of the solution
• Service Authorization Support Services
• Clinical reviews and development of clinical criteria
• Service Authorization reporting
• Call Center support for members and providers
• Contact Management for all SA activities
• Program management, including CMS initial certification and on-going reporting