Description
The State of South Dakota’s Bureau of Human Resources & Administration (BHRA) is seeking a qualified audit firm to perform a three‑year performance audit of the State Employee Health Plan’s medical claims administered by Wellmark. The contractor will conduct a full‑population electronic review of all paid medical claims (≈ 314,300 claims, $108 M FY 2026) and a detailed statistical sample of 200 claims per year, including 50 DRG hospital claims and 20 out‑of‑network claims. Work must follow GAGAS performance‑audit standards, comply with HIPAA/BAA requirements, and be delivered remotely with no on‑site requirement. Deliverables include annual audit reports, findings, recommendations, and data tables for State access.