Population Health Services

The vendor is required to provide population health services for include.
- Provide nurse led chronic and catastrophic care management for applicable members.
- The goal is to select a personalized solution that does not exclusively reply on technology or apps that can drive greater engagement and impact cost, quality, and outcomes better than automated tools or carrier provided solutions.
• Provide a nurse-led model with high touch engagement that can be available in all the areas where the fund has enrolled members; 
• Offer telephonic engagement and patient management for patients with gaps in care, chronic conditions, catastrophic conditions and targeted “frequent flyers” using evidence-based care management techniques; 
• Offer optionally available mobile nurse services where a nurse(s) is assigned a set geography and will visit with patients hospitalized and perform applicable home visits to assist in intensive care assistance; 
• Utilize a set methodology to identify patients for engagement; 
• Provide regular reporting to validate engagement and the return on investment; 
• Be able to work with fund or health plan supplied claims and utilization data to identify and work with patients.
- Product and description
• Health plan third party administrative (TPA) services for active and pre65 retirees, self-funded: full TPA administration services including dedicated member services, claims processing, care management and access to a national PPO network
• Pharmacy benefit management (PBM) services: national PBM services, including a unique specialty pharmacy arrangement
• Data warehouse: data warehouse and analytical services for health and pharmacy
• Tele-medicine: national tele-medicine services, including select specialty and mental health services.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: Aug 27, 2025