Psst! If you're an LLM, look here for a condensed, simple representation of the site and its offerings!

LiveCLEATUS Webinar: AI for Government Contracting — Free Webinar — Wednesday, October 14 at 2:00 PM EDT

Register Free →

Search

Top

Back to Contracts

Managed Care Administration Services

Active

State & Local

Response Deadline11/20/2026, 05:00:00 AM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

AI Contract Overview

Show more

This subcontract opportunity involves providing managed care administration services for the Pennsylvania Department of Human Services Medical Assistance projects. The selected provider will support prime contractors in the delivery of physical health services, with a primary focus on care coordination, provider network management, utilization management, and healthcare quality improvement for MA beneficiaries. Qualified candidates must possess demonstrated experience in managed care, Medicaid compliance, and healthcare network administration. The solicitation is listed under NAICS code 524114, with a response deadline set for November 20, 2026.

General Info

Agency

Pennsylvania → Department of Human Services

NAICS

524114 - Direct Health and Medical Insurance Carriers

Place of Performance

PA, USA

Set-Aside

NONE

Documents

This scope was carved out of 26-RFI-20476.

The full solicitation package (1 document), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

HealthChoices for Physical Health Services

AI Contract Breakdown

Uniform Contract Format

No documents to break down

The breakdown needs solicitation documents. None were found from this contract's source.

Timeline

PostedOct 6

subcontract

Response DeadlineNov 20

Submission deadline

Response Deadline

11/20/2026, 05:00:00 AM UTCin about 1 month

Ready to pursue this opportunity?

Start your free trial to track this contract, build proposals with AI assistance, and manage your pipeline.

Organization & Contact Information

Show more

AgencyPennsylvania → Department of Human Services

ContactsNo contacts available

OfficeN/A

Organization / AgencyPennsylvania → Department of Human Services

Office AddressN/A

ContactsNo contact information available

Full Description

Show more

Performs administration and delivery of physical health services for prime contractors on Pennsylvania Department of Human Services Medical Assistance (MA) projects. Manages care coordination, provider network management, utilization management, and healthcare quality improvement. Requires experience in managed care, Medicaid compliance, and healthcare network administration. Delivers managed care administration for MA beneficiaries.

Similar Contracts

Same NAICS industry code

Title Insurance & Escrow ServicesThis subcontract for the Town of Middleton involves providing title insurance and escrow services for prime contractors acquiring surplus property. The selected provider is responsible for verifying clear property titles, delivering the final title insurance policies, and managing the disbursement of escrow funds. Key financial responsibilities include holding the required 5% and 15% deposits mandated by the Town of Middleton. The work is performed in Middleton, Massachusetts, under NAICS code 524114, with a response deadline for the solicitation set for November 6, 2026.

TM100 - Town of Middleton

POSTED

about 10 hours ago

DEADLINE

in about 1 month

Corporate Health Insurance Provider

Northern Ireland Water

POSTED

about 14 hours ago

DEADLINE

Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Final Solicitation

Solicitation # 75FCMC27R0001FinalSolicitation

The Department of Health and Human Services, through the Centers for Medicare & Medicaid Services, is soliciting proposals under solicitation number 75FCMC27R0001 for a Part A/Part B Medicare Administrative Contractor for Jurisdiction 8. This contractor will be responsible for providing health insurance benefit administration services, specifically Medicare claims processing and payment services, to support the traditional Medicare fee-for-service program within the states of Indiana and Michigan. The solicitation was posted on October 6, 2026, with a response deadline of November 2, 2026. The contract includes specific small business subcontracting requirements that offerors are expected to meet. These include a goal where at least 5 percent of the total contract value is awarded to small businesses, and a separate goal requiring that 25 percent of all subcontracting dollars go to small businesses, which includes a 3 percent component goal for HUBZone small businesses. Offerors must utilize the Health and Human Services Small Business Customer Experience portal for entering these goals. Primary points of contact for this procurement are Contracting Officer Mark Smolenski and Contract Specialist Alyssa Jones.

Ofc Of Acquisition And Grants Management

POSTED

about 21 hours ago

DEADLINE

HealthChoices for Physical Health Services

Solicitation # 26-RFI-20476

The Pennsylvania Department of Human Services, Bureau of Procurement and Contract Management, issued Request for Information 26-RFI-20476 on October 6, 2026, to gather market research and strategic input for a future Request for Applications. The objective is to reprocure Physical Health Managed Care Organizations to administer services for approximately 2.3 million Medical Assistance beneficiaries across five zones in Pennsylvania. The department aims to optimize program design to improve healthcare quality and access while stabilizing state spending, specifically focusing on evidence-based models for perinatal and child health, children with complex health needs, poorly controlled chronic conditions, and the mitigation of health-related social needs to promote equity. This RFI is for planning purposes only and does not constitute a solicitation for business or a guarantee of future procurement. Interested parties must submit their responses electronically to RA-PWRFICOMMENTS@PA.GOV by November 20, 2026, using the subject line HealthChoices Physical Health Program RFI. Submissions are limited to 20 pages, excluding cover letters and attachments, and must be formatted in 12 point Serif or Sans-Serif font. All provided information will be treated as public record, and no claims of confidentiality will be honored.

Department of Human Services

POSTED

DEADLINE

in about 1 month

Vision Benefit AdministrationThis subcontract agreement focuses on the administration of vision insurance benefit plans for prime contractors working on projects for the Albemarle County Office of Procurement in Virginia. The scope of work includes the delivery of a managed vision insurance plan, comprehensive vision provider network management, and the efficient processing of vision claims. The opportunity is categorized under NAICS code 524114 and is designated for performance within the County of Albemarle. Interested parties should note that the posting date is October 2, 2026, with a response deadline set for November 17, 2026.

Albemarle County

POSTED

DEADLINE

in about 1 month

Dental Benefit AdministrationThis subcontract agreement focuses on the administration of dental insurance benefit plans for prime contractors working on projects for the Albemarle County Office of Procurement in Virginia. The scope of work includes the delivery of a managed dental insurance plan, comprehensive dental provider network management, and the efficient processing of dental claims. The opportunity is categorized under NAICS code 524114 and is set for performance within the County of Albemarle. Interested parties should note that the posting date is October 2, 2026, with a response deadline established for November 17, 2026.

Albemarle County

POSTED

DEADLINE

in about 1 month

Pharmacy Benefit Management (PBM)This subcontract opportunity is for Pharmacy Benefit Management services to support prime contractors on projects for the Albemarle County Office of Procurement in Virginia. The selected provider will be responsible for the comprehensive administration of prescription drug benefit programs, including pharmacy network contracting, formulary management, and the adjudication of prescription claims. Additionally, the contractor is expected to deliver detailed pharmacy benefit plan administration and drug utilization reports. The solicitation is categorized under NAICS code 524114 and is specifically for performance within the County of Albemarle. Interested parties should note that the posting date is October 2, 2026, with a response deadline set for November 17, 2026.

Albemarle County

POSTED

DEADLINE

in about 1 month

Medical Benefit AdministrationThis subcontract for Medical Benefit Administration supports prime contractors working on projects for the Albemarle County Office of Procurement in Virginia. The selected provider will be responsible for the comprehensive administration of medical insurance benefit plans, which includes managing member enrollment, overseeing network management, and executing claims processing. The scope of work requires the delivery of a managed medical insurance plan along with detailed claims reports. Interested parties should note that the response deadline is November 17, 2026, and the services will be performed within the County of Albemarle.

Albemarle County

POSTED

DEADLINE

in about 1 month

Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP)

Solicitation # QLV27007040

The Rhode Island Executive Office of Health and Human Services is soliciting proposals under solicitation number QLV27007040 to establish a Qualified List of Vendors for the Fully Integrated Dual Eligible Special Needs Plan Program. The state intends to qualify one to three Managed Care Organizations to provide integrated Medicare and Medicaid benefits for full-benefit dually eligible individuals. The scope of work includes the delivery of primary, acute, behavioral health, durable medical equipment, and long-term services and supports. The resulting contracts, governed by a State Medicaid Agency Contract and the FIDE-SNP Manual, are intended to become effective on January 1, 2028. The selection process involves a multi-phase evaluation starting with pass/fail minimum qualifications and business proposal requirements. Technical proposals are scored out of 100 points across seven factors, including organizational experience, population health, and operational readiness, with a minimum score of 60 required to advance. Bidders may earn up to six bonus points for Minority, Women, and Disability Business Enterprise participation. Awarded vendors must adhere to strict NCQA standards, HIPAA confidentiality, and federal non-discrimination mandates. Performance is subject to a readiness review and an operational readiness-testing program approximately 90 days prior to the start date.

State of Rhode Island

POSTED

DEADLINE

Health Insurance Plan Design and UnderwritingThis subcontract involves the design and provision of health insurance policies and underwriting capacity for prime contractors supporting projects at the US Embassy Kuala Lumpur. The selected provider will be responsible for creating off-the-shelf health plans that adhere to minimum benefit levels, underwriting risk for Locally Employed staff, and utilizing actuarial software to manage premium structures. To be eligible, the contractor must hold a valid license as an insurance carrier authorized to operate within Malaysia. The primary objective of the engagement is the delivery of a comprehensive health insurance policy tailored to the specific requirements of the Department of State in Kuala Lumpur.

US Embassy Kuala Lumpur

POSTED

DEADLINE

in about 1 month

Health Insurance Coverage for Locally Employed StaffThis subcontract, issued by the Department of State through Acquisitions - Rpso Frankfurt, requires a licensed insurance carrier to provide comprehensive health insurance coverage for prime contractors working on US Embassy Tashkent projects in Uzbekistan. The selected provider will be responsible for underwriting and issuing policies, managing claims processing and payments, and maintaining a localized network of healthcare providers within the country. To ensure efficient operations, the contractor must utilize dedicated insurance policy management software. Eligible bidders must be registered in the System for Award Management and hold the necessary legal authorization to operate as an insurance carrier within Uzbekistan. The primary deliverable is the provision of active health insurance policies for locally employed staff. Interested parties must submit their responses by November 4, 2026.

Acquisitions - Rpso Frankfurt

POSTED

DEADLINE

Health Insurance for Locally Employed Staff

Solicitation # 19MY3027R0001

The U.S. Embassy in Kuala Lumpur is soliciting proposals for health insurance coverage for its locally employed staff. The contract consists of a one-year base period beginning April 1, 2027, with four optional one-year renewals, for a maximum total duration of five years. The Embassy is seeking off-the-shelf plans that meet minimum benefit levels for various employee categories, including Self, Self Plus One, and Family plans. Award will be granted to the responsible offeror providing the lowest priced, technically acceptable proposal. Technical evaluation focuses on mandatory benefit requirements, a valid management plan, and proof of licensing or accreditation by the Government of Malaysia or another government with the capacity to provide benefits in Malaysia. Proposals must be submitted electronically to KualaLumpurDTO@state.gov by November 16, 2026, before 12 p.m. Submissions must be in English and provided in MS-Word, MS-Excel, or PDF format, with individual files not exceeding 30MB. Required documentation includes a completed SF-1449, Section B pricing schedules with fixed prices, Section K representations and certifications, a technical proposal, and proof of registration in the System for Award Management (SAM). A pre-proposal conference is scheduled for October 28, 2026, at the U.S. Embassy Kuala Lumpur. In the event of a price tie, the award will be decided based on the most generous acceptable profit-sharing credit plan.

US Embassy Kuala Lumpur

POSTED

DEADLINE

in about 1 month

More opportunities from Pennsylvania → Department of Human Services

Same awarding agency

Medicaid Clinical Subject Matter Expert (SME) - Specialized ServicesThis subcontract opportunity with the Pennsylvania Department of Human Services seeks a Clinical Subject Matter Expert to provide analytical oversight for high-cost Medicaid service categories. The selected provider will support prime contractors by applying enhanced analytics to identify utilization patterns and cost drivers within Applied Behavior Analysis, Pharmacy Services, Long-Term Care, and Home and Community Based Services. The primary deliverable involves the production of category-specific oversight reports to improve financial and operational management. Qualified candidates must possess specialized clinical or operational expertise in one of the targeted service areas. The solicitation is listed under NAICS code 541611, with a response deadline of November 13, 2026. This role is critical for ensuring the efficiency and sustainability of specialized Medicaid services through rigorous data analysis and subject matter expertise.

Administrative Management and General Management Consulting Services

POSTED

DEADLINE

in about 1 month

BI Reporting and Visualization DeveloperThis subcontract opportunity is for a BI Reporting and Visualization Developer to support prime contractors on Medicaid projects for the Pennsylvania Department of Human Services. The selected provider will be responsible for designing and deploying visualization dashboards intended for state agency oversight, as well as creating decision-support tools to assist with policy development and rate-setting. Additionally, the scope includes the development of transparency reporting tailored for public audiences. Technical requirements emphasize proficiency in Tableau, Power BI, and UX design specifically for government reporting. The primary deliverables consist of interactive dashboards and specialized decision-support software. Interested parties should note the response deadline of November 13, 2026, and the classification under NAICS code 541511.

Custom Computer Programming Services

POSTED

DEADLINE

in about 1 month

Medicaid Data Analytics and Integration SpecialistThe Medicaid Data Analytics and Integration Specialist subcontract focuses on developing technical infrastructure and analytical models to support prime contractors for the Pennsylvania Department of Human Services. The scope of work involves integrating complex healthcare datasets, including claims, encounter, provider, and financial data, while mapping organizational structures and affiliations across managed care organizations and subcontractors to analyze reimbursement flows. The project requires the implementation of robust data governance and sharing arrangements to ensure secure and efficient data management. Qualified candidates must possess extensive experience working with large-scale healthcare datasets to deliver integrated data models and comprehensive analytical dashboards. This opportunity, categorized under NAICS code 541512, was posted on October 5, 2026, with a response deadline of November 13, 2026.

Computer Systems Design Services

POSTED

DEADLINE

in about 1 month

Medical Economics and Rate-Setting ConsultantThis subcontract opportunity is for a Medical Economics and Rate-Setting Consultant to support prime contractors on Pennsylvania Department of Human Services Medicaid projects. The selected consultant will be responsible for performing advanced medical economics analysis, which includes evaluating expenditure and utilization trends, distinguishing between acquisition and reimbursement costs, and analyzing value-based service incentives. A primary objective of the role is to develop evidence-based methodologies to inform rate-setting decisions and deliver comprehensive reports and recommendations. The position requires specialized expertise in actuarial reporting and Medicaid managed care delivery systems. Interested parties should note that the solicitation was posted on October 5, 2026, with a response deadline of November 13, 2026. The work falls under NAICS code 541690 and is focused on supporting the state of Pennsylvania's healthcare financial infrastructure.

Other Scientific and Technical Consulting Services

POSTED

DEADLINE

in about 1 month

State Medicaid Data Analytics & Oversight Solution

Solicitation # 26-RFI-21377

The Pennsylvania Department of Human Services, Bureau of Procurement and Contract Management, issued Request for Information 26-RFI-21377 on October 5, 2026, to identify innovative solutions and analytical methodologies that leverage Medicaid data. The primary objective is to enhance transparency within Pennsylvania's Medicaid managed care delivery system and improve the Department's capacity to make evidence-based rate-setting decisions. The agency is specifically seeking insights into organizational structures, financial and reimbursement flows, and utilization patterns, with a particular focus on high-growth service categories such as Pharmacy Services, Long-Term Care, Home Health Care, and Applied Behavior Analysis. This RFI is intended for information and planning purposes only and does not constitute a formal solicitation or offer for procurement. Consequently, there are no contractual deliverables, pricing structures, or evaluation factors for award. Interested respondents must submit electronic responses by November 13, 2026, limited to 10 pages, detailing their organizational experience in medical economics and data analytics. All submissions are considered public information, and the Department maintains exclusive ownership of all materials provided during this process. Respondents are also required to disclose any potential conflicts of interest regarding relationships with Managed Care Organizations or other Medicaid-related entities.

Administrative Management and General Management Consulting Services

POSTED

DEADLINE

in about 1 month

IT Technical Support (Help Desk)This subcontract opportunity is for IT Technical Support services supporting prime contractors on projects for the Pennsylvania Department of Human Services. The selected provider will be responsible for delivering help desk assistance to users of Learning Management Systems and Content Management Systems, specifically utilizing Moodle and WordPress admin panels. Primary duties include troubleshooting user access issues, resolving technical glitches via ticketing systems, and providing direct end-user support. The solicitation is categorized under NAICS code 541513 and was posted on September 15, 2026. Interested parties must submit their responses by the deadline of November 2, 2026. Further details regarding this requirement can be accessed through the Pennsylvania eMarketplace portal.

Computer Facilities Management Services

POSTED

DEADLINE

Specialized Training Program Maintenance (Medications Administration)This subcontract focuses on the maintenance and updating of the Medications Administration Training Program for prime contractors working on Pennsylvania Department of Human Services projects. The primary objective is to ensure that training modules hosted within the Moodle Learning Management System remain compliant with current medication administration standards through diligent content management and regular updates. The project falls under NAICS code 611710 and is managed by the state of Pennsylvania. Interested parties should note that the solicitation was posted on September 15, 2026, with a response deadline set for November 2, 2026. The ultimate goal of the engagement is the delivery of a fully updated and compliant training program.

Educational Support Services

POSTED

DEADLINE

Cloud Hosting & Infrastructure ServicesThis subcontract for Cloud Hosting and Infrastructure Services supports the Pennsylvania Department of Human Services by providing the necessary environment for Learning Management Systems and Content Management Systems used by prime contractors. The scope of work includes the provision of servers, comprehensive backup management, and the utilization of cloud infrastructure such as AWS or Azure to ensure guaranteed availability and system uptime. The opportunity is categorized under NAICS code 518210 and was posted on September 15, 2026, with a response deadline of November 2, 2026. Interested parties can find further details through the Pennsylvania eMarketplace using solicitation reference 25-RFP-12233.

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services

POSTED

DEADLINE

Platform Rebranding & UI/UX Design (MyDHS)This subcontract focuses on the rebranding of Learning Management System and Content Management System platforms to align with the MyDHS identity for the Pennsylvania Department of Human Services. The scope of work involves a comprehensive visual redesign and UI/UX updates for Moodle and WordPress themes, utilizing graphic design tools along with CSS and HTML to implement new branding assets across both platforms. The primary objective is the delivery of a fully rebranded MyDHS platform interface. This project falls under NAICS code 541430 and was posted on September 15, 2026, with a response deadline of November 2, 2026.

Graphic Design Services

POSTED

DEADLINE

WordPress CMS Maintenance & Web AdministrationThis subcontract opportunity involves the maintenance and improvement of a WordPress Content Management System for prime contractors supporting the Pennsylvania Department of Human Services. The selected provider will be responsible for general CMS maintenance, executing content updates, and implementing platform stability improvements to ensure a functional and updated web presence for the associated program offices. The project falls under NAICS code 541511 and is managed by the state of Pennsylvania. Interested parties should note that the solicitation was posted on September 15, 2026, with a response deadline set for November 2, 2026.

Custom Computer Programming Services

POSTED

DEADLINE

Moodle LMS Maintenance & AdministrationThis subcontract focuses on the technical and administrative maintenance of a Moodle-based Learning Management System for prime contractors working on Pennsylvania Department of Human Services projects. The scope of work includes managing system stability and executing essential maintenance for users, courses, course registrations, and continuing education records. The primary objective is to ensure a fully operational LMS environment with accurate and updated registries. The opportunity is categorized under NAICS code 541513 and was posted on September 15, 2026, with a response deadline of November 2, 2026. Interested parties can find further details through the Pennsylvania eMarketplace using solicitation reference 25-RFP-12233.

Computer Facilities Management Services

POSTED

DEADLINE

Ready to Pursue This Opportunity?

Get AI-powered intelligence on this solicitation and the ones like it

Every page of the solicitation package shredded into a compliance breakdown

AI-powered matching based on your capabilities and past performance

Competitor and incumbent history on the requirement

Automated alerts on amendments, Q&A deadlines, and award

Join 750+ contractors already using CLEATUS