Multnomah County Medical Claims Audit RFP-12-2027 - Self-Insured Health Plans
- Due
- Sep 23, 2026
- Deadline passed
- Posted
- Aug 21, 2026
- Contract term
- 5 years
- Primary contact
- Jun Zhu
- (503) 988-7603 ext 87603
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THE 30-SECOND BRIEF
Multnomah County is seeking a qualified vendor to conduct a comprehensive Medical Claims Audit of its self-insured health plans. The scope includes conducting medical, prescription, and dental audits of self-funded health plans to ensure fiscal accountability, verify compliance with plan documents, and identify opportunities for cost recovery and process improvement. Vendors must provide stakeholder engagement, quality assurance, a knowledge transfer plan, and address data security compliance under HIPAA and HITECH. Proposals are due by September 23, 2026, at 4:00 PM PDT via the Multco Marketplace Supplier Portal. The resulting contract term is not to exceed five years.
Programmatic Questions 75%, Responsible Business Practice Questions 25%
SUMMARY
Multnomah County is seeking a qualified vendor to conduct a comprehensive Medical Claims Audit of its self-insured health plans.
The scope includes conducting medical, prescription, and dental audits of self-funded health plans to ensure fiscal accountability, verify compliance with plan documents, and identify opportunities for cost recovery and process improvement. Vendors must provide stakeholder engagement, quality assurance, a knowledge transfer plan, and address data security compliance under HIPAA and HITECH. Proposals are due by September 23, 2026, at 4:00 PM PDT via the Multco Marketplace Supplier Portal. The resulting contract term is not to exceed five years.
EVALUATION CRITERIA
Programmatic Questions 75%, Responsible Business Practice Questions 25%
REQUIRED STAFFING
3- Submit to
- https://app01.jaggaer.com/apps/Router/ViewSourcingEvent
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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. Submissions should be delivered to: https://app01.jaggaer.com/apps/Router/ViewSourcingEvent. 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: audit, consulting, health plan administration. Proposers should demonstrate relevant qualifications and experience for each required role.
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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 Practice 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. Additionally, proposals should address staffing requirements as outlined in the solicitation. Review the full document from Multnomah County for the complete list.