Multnomah County Medical Claims Audit Request for Proposal RFP-12-2027
Multnomah CountyCounty · Portland, OR- Due
- Sep 30, 2026
- Deadline passed
- Posted
- Aug 21, 2026
- Contract term
- 5 years
- Primary contact
- Jun Zhu
- (503) 988-7603 ext 87603
The 30-second brief
Multnomah County seeks a qualified vendor to conduct a comprehensive medical claims audit, prescription audit, dental audit, and operational assessment of its self-funded health plans. The contractor will ensure fiscal accountability, verify compliance with plan documents, perform 100 percent electronic claims audits and targeted sample audits, and identify opportunities for cost recovery and process improvement. Approximately 2,300 employees and retirees are enrolled in PPO medical plans and 2,600 in self-funded dental plans. The project involves stakeholder engagement plans, quality assurance, knowledge transfer, corrective action plan (CAP) monitoring, and data security compliance under HIPAA and HITECH. The submission deadline is September 30, 2026, at 4:00 PM PT. Proposals will be evaluated based on programmatic questions (75%) including methodology, experience, fees, data security, and responsible business practices (25%).
Programmatic Questions (75%), Responsible Business Practices Questions (25%)
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Summary
Multnomah County seeks a qualified vendor to conduct a comprehensive medical claims audit, prescription audit, dental audit, and operational assessment of its self-funded health plans.
The contractor will ensure fiscal accountability, verify compliance with plan documents, perform 100 percent electronic claims audits and targeted sample audits, and identify opportunities for cost recovery and process improvement. Approximately 2,300 employees and retirees are enrolled in PPO medical plans and 2,600 in self-funded dental plans. The project involves stakeholder engagement plans, quality assurance, knowledge transfer, corrective action plan (CAP) monitoring, and data security compliance under HIPAA and HITECH. The submission deadline is September 30, 2026, at 4:00 PM PT. Proposals will be evaluated based on programmatic questions (75%) including methodology, experience, fees, data security, and responsible business practices (25%).
EVALUATION CRITERIA
Programmatic Questions (75%), Responsible Business Practices Questions (25%)
- Submit to
- https://app01.jaggaer.com/apps/Router/ViewSourcingEvent?AuthToken=1%3AAES2%23CNWGDOHYPkWFrH9Vqz%2BInfJJkPX7W8w%2F1LB0UCY
- Scope location
- Portland, OR
Questions about this RFP
How do I respond to this RFP from Multnomah County?
Review the full solicitation document for submission requirements, evaluation criteria, and deadlines. The submission deadline is September 30, 2026. Submissions should be delivered to: https://app01.jaggaer.com/apps/Router/ViewSourcingEvent?AuthToken=1%3AAES2%23CNWGDOHYPkWFrH9Vqz%2BInfJJkPX7W8w%2F1LB0UCY. For questions, contact Jun Zhu.
Can small businesses or minority-owned firms bid on this RFP?
Most government agencies, including Multnomah County in OR, encourage participation from small businesses, minority-owned, women-owned, and disadvantaged business enterprises (MBE/WBE/DBE). Check the full solicitation for any small business participation goals.
What happens after the RFP submission deadline?
After the deadline, the issuing agency reviews all submissions against the stated evaluation criteria. This typically includes a compliance check, technical evaluation, cost analysis, and may involve oral presentations with shortlisted vendors.
Can I ask questions about this solicitation before submitting?
Yes, most solicitations allow vendors to submit questions during a designated period. The primary contact is Jun Zhu at (503) 988-7603 ext 87603. Questions and answers are typically shared with all prospective bidders.
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What are the evaluation criteria for this solicitation?
This solicitation includes specific evaluation criteria that will be used to score proposals. The criteria include: "Programmatic Questions (75%), Responsible Business Practices Questions (25%)" Vendors should carefully align their proposals with each criterion to maximize their score.
Where can I find more RFPs from Multnomah County?
All active and historical solicitations from Multnomah County are tracked and searchable. As a county agency, Multnomah County regularly publishes solicitations. Visit the agency profile to see current open bids, past contracts, vendor relationships, and decision-maker contacts.
What is the contract term for this solicitation?
The anticipated contract term is 5 years. Contract terms may include renewal options.
What documents are required to bid on this RFP?
Requirements vary by solicitation, but common documents include a technical proposal, cost/price proposal, proof of insurance, relevant certifications, past performance references, and any forms specified in the solicitation. Review the full document from Multnomah County for the complete list.
What is the scope of this project?
This solicitation defines a specific project scope. The scope covers the following locations: Portland, OR. Review the full solicitation for detailed scope requirements.