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IFM Predictive Analytic Consultant
10/14/2024
$200,000.00
California
Covered California
The buyer seeks a consultant to review and evaluate their Integrated Fraud Management processes. The consultant will assess operational efficiency, enhance the fraud management framework, and model best practices. They will also identify challenges and risks, and compare the buyer's practices to federal and state agency requirements. The project aims to improve compliance and refine policies, procedures, reports, and systems related to fraud management.
- 9/10/2024 - RFP Questions Due Date
- 9/20/2024 - Responses to Questions Posted By
- 10/14/2024 - Proposal Due Date
- 10/28/2024 - Notice of Intent to Award
- 12/1/2024 - Anticipated Contract Term Start
- Ten years experience with consumer experience strategies and fraud, waste, and abuse knowledge
- Three years understanding healthcare industry regulatory environment
- Three years in data analysis and identifying operational improvements
- Three years working in the healthcare industry
- Review and evaluate current operational processes
- Enhance and refine fraud management framework
- Model best practices for fraud prevention and detection
- Identify challenges and risks in fraud management
- Compare IFM to improve compliance with federal and state agencies
- Review and refine policies, procedures, reports, and systems
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