The Vendor is required to provide for the establishment, operations and ultimate expansion of a technology platform to be shared by Customer Service Center (CSC) and State staff.
- This CSC is to provide prompt, accurate, and consistent information regarding programs, questions, and concerns in a streamlined and holistic manner that is easy to navigate for beneficiaries.
- The volume of programs and beneficiaries often require subject matter expertise that the current beneficiary call line is not capable of resolving directly.
- Many customer inquiries are often transferred multiple times before landing with a State employee who can directly address the caller’s needs. Beneficiaries are often passed through multiple interactive voice response systems (IVRS) and transferred between several State employees before the inquiry is routed to someone that can address the specific caller’s needs.
- Backup restore testing shall be conducted at least annually, and additionally upon significant changes to systems, infrastructure, or business processes. Testing shall simulate real-world failure scenarios to validate both data recovery and system restoration capabilities.
- Tests shall include validation of full and partial restores of production data and system configurations
- A worst-case scenario in which a man-made or natural disaster, data center equipment or infrastructure failure, or total system failure results.
- Data on CSC performance including but not limited to:
• Call volume;
• Average length of interaction;
• Summary of call types;
• Resolution rates; and
• Transfer rates
- Configuration management summary providing a high-level overview of any changes to the CSC System’s baseline configuration;
- Accomplishments and setbacks during the last reporting period, including any tasks that started or finished late and the root causes of delays;
- A customer requests that their personal information (i.e. address change) be updated with the State.
- Determine customer coverage, geographic location, age, and Medicare/Medicaid plans.
- A customer calls with a complaint regarding a Medicaid provider.
- A customer calls to report elder abuse or adult maltreatment.
- A customer calls seeking crisis services.
- A customer calls seeking information on involuntary commitment on behalf of a family member.
- A customer calls seeking information about Medicaid claims or explanation of benefits under their particular Medicaid category.
- A customer requests information on the competency restoration of a person awaiting trial, on behalf of the customer or the customer’s family member(s).
- Contract Period/Term: 5 years
- Questions/Inquires Deadline: January 30, 2026
