Specifications include, but are not limited to: CareOregon is seeking the services of a risk consulting group to review our 2021 claims data to evaluate our CareOregon Advantage risk adjustment processes, uncover gaps or issues, and advise on how to fix them. We are seeking recommendations of specific process improvement programs, strategies, and future areas of opportunity to safeguard capture of appropriate Hierarchical Condition Categories (“HCC”) coding. We need recommendations on future state process improvements to ensure optimal, complete, accurate, and compliant risk adjustment data capture, submission, and Risk Assessment Factor (“RAF”) scores. This information will allow us to better care for our members, achieve higher quality outcomes, and enhance forecasting for budgets and our annual Medicare bid submissions. The claims analysis should span as much of the data flow pipeline as possible – from a member’s initial visit with a provider to risk scoring by CMS, including review of vendor processes.