Clinical Review & Pharmacist Support Services

The contract seeks qualified vendors to provide licensed pharmacists and clinical staff dedicated to reviewing prior authorization denials and evaluating letters of medical necessity for healthcare services. The primary responsibility involves conducting thorough clinical assessments to determine the appropriateness of care requests, identifying grounds for appeals, and engaging directly with healthcare providers to clarify documentation, resolve discrepancies, and submit compliant appeals. Communication with providers is a critical component, ensuring timely and accurate information exchange to support timely patient access to necessary treatments. Services must be delivered under an agreement designated as a subcontract with Sfaa Procurement Services on behalf of South Carolina, with all work expected to comply with state-specific healthcare frameworks and regulatory standards. Responses are due by September 1, 2026, and the North American Industry Classification System code 621399 indicates the scope encompasses other miscellaneous ambulatory health care services. The performance location is unspecified but presumed to align with South Carolina’s operational requirements, and interested parties must submit proposals through the state’s online procurement portal by the stated deadline.