Description
The State of New Jersey is seeking an Independent Utilization Review Organization (IURO) to provide independent health‑care appeals reviews for the Department of Banking and Insurance’s Independent Health Care Appeals Program. The contractor will perform three types of reviews—preliminary, full, and expedited—on a firm‑fixed‑price basis, using the State‑Supplied Price Sheet. The contract is a three‑year base award with up to two one‑year extensions and is set‑aside for Small‑Business and Disabled‑Veteran‑Business subcontracting. All quotes must be submitted electronically via NJSTART, and the award will be governed by the State’s Combined Standard Terms & Conditions, which include extensive security, insurance, and reporting requirements.
• Conduct Preliminary, Full, and Expedited utilization reviews of health‑care appeals (≈ 4 k prelim, 2 k full, 1.5 k expedited annually).
• Submit pricing on the State‑Supplied Price Sheet (firm‑fixed price per review) and comply with detailed security, privacy, and reporting obligations.
• Contract term: 3‑year base, with optional 1‑year extensions (max 5 years); subcontracting must meet SBE/DVOB set‑aside goals.
• Electronic submission only (NJSTART); mandatory pre‑quote conference (optional) on July 23 2026; Q&A closes August 6 2026; final quote deadline October 6 2026.