MB-10479 - USA (Pennsylvania) - Workers Compensation Managed Care Consultant Service - Deadline October 16,2026

(1) Vendor needs to provide workers compensation managed care consultant service. – To provide the City with guidance and recommendations to optimize the City’s program savings, conduct program evaluations and implement the highest performing, cost–effective employee disability program for the city and its employees.– This work will include Managed Care Program analysis and monitoring, increasing transparencies in the managed care process, financial analyses, medical bill review process analysis, recapture of overcharges and overpayments to medical providers, identifying program deficiencies and corrective measures, developing corrective program strategies, assisting thee City in the process for Third Party Administrator services and assisting the City in negotiating and enforcement of contract/performance terms, as directed by the City.• Managed Care Program analysis and oversight • Managed Care Program monitoring • Recapture of overcharges/overpayments • Financial analysis • Medical Bill Review Process analysis • Develop corrective program strategies • program analysis • Large loss bill review • Evaluations on proposals received for the City’s Employee Disability Program TPA • Establish program baseline savings value, structure, and metrics • Establish program fee goals • Provide program enhancements (i.e., restructuring program) • Implement corrective measures based on statistical findings • Prepare reports based on statistical program evaluations • Implement corrective measures for program deficiencies • Provide Fee structure and savings performance analysis & reporting • Track and measure Utilization Reviews • Attend periodic meetings with City personnel • Prompt reporting of significant program findings to the city. • Assist the City in negotiating and enforcement of contract/performance terms, as directed by the City. (2) The contract period will be one year.