RFP for Provider Data Management services

MetroPlusHealth is seeking a qualified vendor to provide a comprehensive Provider Data Management and Maintenance solution that supports the end-to-end lifecycle management of provider data across multiple lines of business and operational functions, including provider network management, credentialing, contracting, claims administration, provider directories, regulatory reporting, and compliance activities. The proposed solution should serve as a centralized platform for the collection, validation, maintenance, distribution, and governance of provider data.

The selected vendor will be responsible for providing the software, professional services, implementation resources, integrations, data conversion, training, documentation, go-live support, and ongoing maintenance necessary to successfully deploy and operationalize the PDM solution.

Solution Delivery

• PDM platform licensing or subscription for the agreed term.
• Production, test, training, and other environments required to support implementation and ongoing operations.
• Configuration of the solution based on approved business and technical requirements.
• Configuration of workflows, matching logic, business rules, validation rules, notifications, and exception handling.
• Environment setup, release management, and deployment support.
• Role-based security, user access controls, segregation of duties, and audit capabilities.

Requirements Validation and Solution Design

• Conduct discovery, requirements validation, and design workshops with business, operational, compliance, and technology stakeholders.
• Develop and maintain an integration, conversion, and data migration strategy.

Provider Data Intake, Maintenance, and Governance

• Ingest provider data from disparate and asynchronous source feeds and layouts, with configurable mapping and matching that minimizes the need for vendor customization.
• Identify and manage duplicate or conflicting provider records using configurable match, merge, survivorship, and exception-management processes.

Integration Development

- Developing integrations using APIs, file-based exchanges, or other approved integration methods.

Data Migration and Conversion

- Perform trial conversions and dress rehearsals before production cutover.

Testing

- Develop a comprehensive test strategy, test plan, test scenarios, scripts, expected results, and traceability to requirements.

Go-Live and Deployment Support

- Provide an agreed period of hypercare and stabilization support, including defined staffing, hours of coverage, triage, escalation, reporting, and transition criteria.

Reporting and Analytics

- Create, validate, schedule, and deliver extracts in the layouts required for New York State PNDS submissions.

Ongoing Support and Maintenance

• Provide product support, incident management, problem management, issue resolution, and escalation.
• Provide software updates, upgrades, patches, security fixes, and enhancements.

Proposers shall submit a complete Proposal Package in electronic format no later than the date and time specified in the RFP Timeline. Proposals must be submitted **by email** to the individual designated on the first page of this RFP.

The term of the contract resulting from this RFP shall be for a term of **3 years with 2 one-year optional renewals**.

Evaluation Criteria

| Category | Weight % |
| --- | --- |
| Quality of proposed approach and adherence to SOW | 20% |
| Relevance of quality of experience | 30% |
| Technical capabilities | 20% |
| Cost | 20% |
| MWBE Utilization Plan or MWBE Status | 10% |

The proposer must meet and attest that it meets all the minimum qualifications, including an *MWBE Utilization Plan, Waiver, or MWBE Certification*. The Technical Proposal shall not exceed twenty (20) pages. The complete Proposal Package shall not exceed twenty (20) megabytes in total file size.