Specifications include, but are not limited to: The County of Santa Clara (County) is seeking proposals from qualified vendors to procure, implement, and maintain an integrated system designed to monitor and manage all aspects of its Managed Care functions. Mandated by both the Department of Healthcare Services (DHCS) and the Centers for Medicare and Medicaid (CMS), this comprehensive solution is crucial for ensuring compliance with regulatory requirements and optimizing the delivery of healthcare services within the county. The Behavioral Health Services Department (BHSD) requires a fully managed care solution that can seamlessly integrate with our existing EHR NetSmart (myAvatar) infrastructure. This integration is essential for streamlining data exchange processes and facilitating efficient communication between various departments and stakeholders within the Behavioral Health Services Department. The County is seeking a proposed hosted solution, which may also be referred to as SaaS (Software as a Service) hosted by either the Vendor or a CSP (Cloud Service Provider). The solution should empower BHSD to fulfill the essential obligations of managed care plan encompassing Utilization Management, Care Monitoring, processing Appeals/Grievances, and standardizing provider/client data. In addition, the solution should develop standardized reporting that tracks and facilitates accurate analysis and reporting.
