Ccrfp for managed care organization
Closed State & local contract opportunity Posted
- Solicitation number
- 25-13
- State
- New Jersey
- Responses due
Opportunity facts
- Jurisdiction
- NIGP code
- UNSPSC codes
- 78100000 Mail and cargo transport
- 70100000 Fisheries and aquaculture
- 70160000 Wildlife and flora
- 70120000 Livestock services
- 85150000 Food and nutrition services
- 70140000 Crop production and management and protection
- 80100000 Management advisory services
- 81140000 Manufacturing technologies
- 80161510 Serious accident prevention and management services
- Points of contact
-
- Nancy Ghani nancyg@permainc.com (201) 518-7029
- Matthew Cavallo mcavallo@laracyllc.com (973) 703-4070
Opportunity details come from bidnetdirect.com. Updated .
About this opportunity
The New Jersey Municipal Excess Liability Joint Insurance Fund (NJMEL) is conducting a Competitive Contracting Request for Proposals (CCRFP 25-13) to procure Managed Care Organization (MCO) services for workers' compensation claims management. The solicitation seeks a qualified vendor to provide comprehensive medical treatment management, billing review, and cost containment services for NJMEL's member Joint Insurance Funds, specifically targeting complex workers' compensation claims including cases involving severe injuries, fatalities, quadriplegia, paraplegia, and long-term disability scenarios. The contract will cover a three-year term from January 1, 2026, through December 31, 2028, with proposals due on November 12, 2025, at 10:00 A.M. Evaluation criteria will total 50 points, distributed across technical aspects (25 points), managerial capabilities (15 points), and cost considerations (10 points). Key deliverables include establishing a comprehensive healthcare provider network, coordinating medical treatments, conducting case management, supporting early return-to-work initiatives, and ensuring compliance with HIPAA and state regulations.
The procurement does not specify explicit set-aside designations or restrictions for disadvantaged enterprises. Proposers must demonstrate extensive workers' compensation claims experience and meet rigorous cybersecurity requirements, including multi-factor authentication, data encryption, and annual cyber hygiene training. Vendors are required to carry cyber liability insurance with $1,000,000 per claim coverage and $250,000 for privacy breach notification. Compliance documentation such as affirmative action certifications, ownership disclosures, and non-collusion affidavits must be submitted with proposals. While a specific contract value is not explicitly stated, the comprehensive nature of the services and the multi-year contract term suggests a significant financial opportunity for the selected MCO. NJMEL reserves the right to interview proposers, request clarifications, and evaluate proposals based on qualifications, management capabilities, references, and overall cost-effectiveness.
Opportunity text
The New Jersey Municipal Excess Liability Joint Insurance Fund (NJMEL) is soliciting proposals from qualified firms to provide Managed Care Organization (MCO) services under a Competitive Contracting Request for Proposals (CCRFP). The selected provider will manage medical treatment, billing review, and cost containment for workers' compensation and related claims across NJMEL's member Joint Insurance Funds. The scope includes network administration, medical case management, compliance with HIPAA and state laws, and coordination with claims administrators to ensure timely, cost-effective, and high-quality care for injured employees.
Files
| File | Type | Posted |
|---|---|---|
| CCRFP 25-13 NJMEL Managed Care.pdf |
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