Multnomah County Medical Claims Audit RFP-12-2027 2026
Multnomah CountyCounty · Portland, OR- Due
- Sep 23, 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 is seeking a qualified vendor to conduct a comprehensive Medical Claims Audit of its self-insured health plans, covering approximately 2,300 employees/retirees in PPO medical plans and 2,600 in dental plans. The scope includes auditing medical, prescription, and dental claims to ensure fiscal accountability, verify plan document compliance, and identify cost recovery opportunities. Requirements include stakeholder engagement with semimonthly progress reports, quality assurance protocols, and knowledge transfer to County staff. A virtual pre-proposal conference is scheduled for September 2, 2026, at 1:30 PM PST. Proposals must be submitted via the County's sourcing portal or to [email protected] by September 23, 2026. Evaluation will be based on methodology, experience (minimum 3 case studies), fees, and responsible business practices including equity and energy conservation.
Stakeholder engagement plan, Semimonthly progress reports, Quality assurance plan, Knowledge transfer plan, Final audit report, Corrective Action Plan (CAP)
Methodology and Approach (15 points), Experience and Qualifications (10 points), Fees and Hourly Rates (10 points), Subcontractor Management (5 points), Conflict of Interest (5 points), Follow-Up and Reporting (10 points), Data Security (5 points), Technology and Tools (8 points), Risk Management (10 points), Innovation (12 points), Performance Metrics (10 points), Energy Conservation (40 points), Equity (30 points), Economic Impact (30 points)
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Summary
Multnomah County is seeking a qualified vendor to conduct a comprehensive Medical Claims Audit of its self-insured health plans, covering approximately 2,300 employees/retirees in PPO medical plans and 2,600 in dental plans.
The scope includes auditing medical, prescription, and dental claims to ensure fiscal accountability, verify plan document compliance, and identify cost recovery opportunities. Requirements include stakeholder engagement with semimonthly progress reports, quality assurance protocols, and knowledge transfer to County staff. A virtual pre-proposal conference is scheduled for September 2, 2026, at 1:30 PM PST. Proposals must be submitted via the County's sourcing portal or to [email protected] by September 23, 2026. Evaluation will be based on methodology, experience (minimum 3 case studies), fees, and responsible business practices including equity and energy conservation.
EVALUATION CRITERIA
REQUIRED DELIVERABLES
6- Stakeholder engagement plan
- Semimonthly progress reports
- Quality assurance plan
- Knowledge transfer plan
- Final audit report
- Corrective Action Plan (CAP)
REQUIRED ATTACHMENTS
4- MMP Supplier Access Request Form
- Representations and Certifications
- Professional Liability Insurance
- Cyber Liability Insurance
REQUIRED STAFFING
role or expertise level
- Submit to
- [email protected]
- Scope location
- Multnomah County, 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 23, 2026. The solicitation specifies required deliverables that must be addressed in your response. Be sure to include all required attachments as outlined in the solicitation. Submissions should be delivered to: [email protected]. 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.
What staffing is required for this project?
This solicitation outlines specific staffing requirements. The required roles include: role or expertise level. Proposers should demonstrate relevant qualifications and experience for each required role.
What are the key deliverables?
The solicitation specifies the following deliverables: Stakeholder engagement plan, Semimonthly progress reports, Quality assurance plan, Knowledge transfer plan, Final audit report, Corrective Action Plan (CAP). Proposals should clearly address how each deliverable will be met.
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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: "Methodology and Approach (15 points), Experience and Qualifications (10 points), Fees and Hourly Rates (10 points), Subcontractor Management (5 points), Conflict of Interest (5 points), Follow-Up and..." 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. This solicitation specifically requires the following attachments: MMP Supplier Access Request Form, Representations and Certifications, Professional Liability Insurance, Cyber Liability Insurance. Additionally, proposals should address staffing requirements as outlined 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: Multnomah County, OR. Review the full solicitation for detailed scope requirements.