Integrated Eligibility System Independent Verification and Validation

New Jersey is seeking an experienced vendor to provide independent verification and validation (IV&V) services for its Integrated Eligibility System (IES) modernization initiative focused on Medicaid eligibility and enrollment. The IES project consolidates and standardizes applications for Medicaid health coverage, replacing outdated legacy systems to enhance program effectiveness.

The selected vendor will be responsible for verifying that the redesigned system supports improvements in health outcomes for eligible clients through timely access and easier enrollment processes, including multiple device options and simplified submission of documentation. The IV&V provider will assess measurable improvements to the Medicaid program associated with new modules or system enhancements, leveraging data and system testing to inform the Centers for Medicare and Medicaid Services (CMS) regarding the project’s success and related funding decisions.

Additional responsibilities include enabling operational reporting on system performance to ensure ongoing oversight and continuous achievement of project outcomes, while reducing the administrative burden during certification activities. The engagement aims to decrease Medicaid eligibility and enrollment error rates and improve managerial oversight of the state Medicaid programs. The initial contract period will be for one year.