High-Cost Claims and Complex Case Management

This subcontract for High-Cost Claims and Complex Case Management provides specialized clinical oversight and coordination for prime contractors operating on University of Arkansas, Fayetteville projects. The scope of work focuses on managing high-cost claims and complex medical cases by integrating care across pharmacy, behavioral health, preventive services, and general medical treatments. To ensure quality and compliance, the contract requires the use of licensed clinical staff, such as Registered Nurses and Case Managers, and mandates healthcare accreditation. Key deliverables include the production of detailed case management reports and the execution of cost-containment audits. Operating under NAICS code 624410, the engagement is designed to optimize healthcare outcomes while controlling expenditures for the university's complex medical cases.