Description
The Ohio Department of Administrative Services is seeking a contractor to deliver comprehensive healthcare navigation services for State employees and retirees. The contractor will act as a single point of contact to help members understand benefits, select providers, schedule appointments, resolve billing issues, and access cost‑transparency tools, while integrating with existing state platforms (OAKS, TPA systems) and meeting strict performance‑based service‑level agreements. The effort includes implementation, ongoing member support, communications, analytics, and a benefits‑fund financial guarantee.
• Provide end‑to‑end member assistance (benefits education, enrollment, claims support, prior‑authorization help) across ~516,000 covered lives.
• Implement technology integrations (single‑sign‑on, data file exchanges, secure SFTP, portal access) and meet State IT policy standards.
• Meet extensive SLAs (call answer times, first‑call resolution, NPS, cost‑savings targets) with fees‑at‑risk tied to performance.