Network, Claims Administration and Medical Management Service

Overview

Healthcare Services, Wellness & Biotech

Baton Rouge, Louisiana, United StatesPosted about 2 months agoDeadline: April 16th, 2026

Fit Score

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SUMMARY

The Baton Rouge government authority is seeking a vendor to provide network, claims administration, and medical management services for its self-funded health plan, focusing on comprehensive provider network and participant support.

KEY REQUIREMENTS

Five years of experience providing medical claims administration with a group size of 15,000 or more covered lives
Licensed and authorized by the Louisiana Department of Insurance

CONTRACT DURATION

60 months

TIMELINE

RFP Posted to LaPAC: March 9, 2026

Deadline to Submit Attachment B: Business Associate Agreement: March 20, 2026

Deadline for Receiving Written Inquiries: March 25, 2026

Issue Responses to Written Inquiries: April 7, 2026

Proposal Due Date and Time: April 16, 2026

Contract Start Date (Proposed): January 1st, 2027

QUESTION DEADLINE

March 25th, 2026

Issuing Agency

Louisiana State University

Organization overview and procurement intelligence available on paid plans.

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DESCRIPTION

The government authority located in Baton Rouge, Louisiana seeks a vendor to deliver comprehensive network, claims administration, and medical management services. Responsibilities include administering claims and network services for a self-funded health plan, managing provider credentialing, maintaining accurate provider data and directories, and ensuring provider networks meet rigorous access, quality, and cost standards.

The selected vendor will also implement and manage health and wellness programs aimed at improving health outcomes and reducing risks among participants. Additional requirements include ongoing account and customer service management, timely processing of claims and reimbursements, ensuring access to account information for participants, and utilizing data analytics to identify high-risk members and support targeted interventions. Coordination of benefits, subrogation, overpayment recovery, appeals processes, and operation of care management programs are also part of the expected services. The contract period will span five years.

Source attribution

This Settle analysis is based on the issuing organization’s public RFP listing.