Medical Staff Credentialing

The Nevada Department of Health and Human Services, Division of Public and Behavioral Health, is soliciting proposals for comprehensive medical staff credentialing services through RFP 40DHHS-S3757. The selected vendor will provide credentialing services for a minimum of 120 healthcare providers and allied health professionals, with at least 20 health insurance provider enrollments per healthcare provider over a four-year contract period from June 10, 2026, through June 30, 2030. Required services include initial credentialing with primary source verification completed within 30 days, re-credentialing within 180 days of expiration, ongoing monitoring of licenses and sanctions, health insurance provider enrollment for commercial and government plans with CAQH platform integration, and secure cloud-based portal access for real-time status updates and compliance tracking. The vendor must maintain HIPAA and Nevada regulatory compliance, provide weekly and monthly reporting with key performance indicators including cycle times and initial credentialing metrics, and deliver automated alert systems for license and credential expirations at intervals of 90, 60, 30, and 15 days before expiration with real-time alerts upon detection of compliance gaps. Proposals must be submitted electronically through nevadaepro.com by April 7, 2026, at 1:00 pm Pacific Standard Time, with questions due by the published deadline through the bid Q&A feature. Vendors must submit a completed Vendor Information Response form, reference questionnaires from current or former clients, a certification regarding lobbying compliance, and a detailed cost schedule covering implementation, enrollment, credentialing, re-credentialing, and ongoing monitoring fees.

The State of Nevada has not identified a specific incumbent vendor for this solicitation. Vendors must comply with Nevada registration requirements, including registration with the State Secretary of State's Office as a foreign corporation if organized outside Nevada and obtaining appropriate Nevada business licensing prior to contract execution. All contractors must maintain comprehensive insurance coverage including Commercial General Liability with limits of $2,000,000 general aggregate and $1,000,000 per occurrence, Automobile Liability with $1,000,000 combined single limit, Workers' Compensation at statutory limits, and Professional Liability (Errors and Omissions) with $1,000,000 per claim and $2,000,000 annual aggregate, with the State named as additional insured on all policies. The RFP does not specify a predetermined contract value or budget range; vendors are responsible for submitting their own pricing proposals through the cost schedule template for all service categories. The State reserves the right to reject any or all proposals, limit scope of work, modify solicitation provisions, and make awards based on the best interest of the State rather than lowest price alone. Payment will be issued within 45 to 60 days of invoice receipt following inspection and acceptance of work, with an optional administrative fee not exceeding one percent of contract value, paid quarterly 45 days after quarter close.