Overflow and After Hours Customer Service Call Center Support and Member Engagement Strategies Services

The vendor is required to provide overflow and after-hours customer service call center support and member engagement strategies services for internal call center, delivering high-quality customer service that aligns with regulatory standards and organizational performance benchmarks.
- Lead strategic outreach initiatives using live calls and interactive voice response (IVR) technologies.
- Agency has multiple product lines and business processes, each requiring different scripting and support.
- Assist with live outbound and inbound call campaigns to members such as welcome and onboarding calls, telephonic health assessments, appointment facilitation to address HEDIS measures, risk adjustment or other gaps in care, post discharge, program enrollment, retention, surveys, or other outreach initiatives.
- Project management
•    Account manager (CAM) as the single point of contact to oversee implementation, service delivery, performance, and reporting.
- Customer service support
•    “Live answer” telephonic answering services, subject to change based on regulatory requirements, during the following times:
o    Overflow and regular business hours, as needed:
1.    One care: 8:00 am-8:00 pm (Mon-Fri)
2.    Medical: 8:00 am-5:30 pm (Mon-Fri)
3.    Covered state: 8:00 am-6:00 pm (Mon-Fri)
o    After-hours, as needed
1.    Saturdays and Sundays all day (24-hour support)
2.    One care: 8:00 pm-8:00 am (Mon-Fri)
3.    Medical: 5:30 pm-8:00 am (Mon-Fri)
4.    Covered state: 6:00 pm-8:00 am (Mon-Fri).
•    Answer calls during agency regular business hours, as needed (i.e., high call volume and call overflow, meetings, training, emergency). 
•    If agency knows of this requirement in advance, agency will endeavor to provide contractor with advance notice. 
•    High call volume or an emergency, contractor may be required to respond without prior notification.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: October 8, 2025