Medicaid Administrative Claiming Support

The Department of Health, Executive Office on Aging, is seeking a qualified contractor to provide technical, administrative, and operational support for Hawaii's Medicaid Administrative Claiming program. The contractor will operate and maintain a federally compliant Random Moment Sampling system, support claim development and calculation activities, provide training and technical assistance to participating agencies, and assist the Executive Office on Aging in preparing quarterly Medicaid Administrative Claims. The contract term is expected to be two years, from September 1, 2026, to August 31, 2028. The maximum compensation available under this procurement for the initial two-year contract term is $350,000. • The contractor shall provide a secure, web-based solution that supports RMS administration, reporting, claim calculation, documentation, and ongoing program management. • The contractor shall have experience implementing, administering, or supporting Medicaid Administrative Claiming programs for state government agencies. • The contractor shall have experience developing, implementing, administering, or supporting Random Moment Sampling methodologies and systems. • The contractor shall have experience supporting Cost Allocation Plans, cost allocation methodologies, and Medicaid administrative claiming processes.