Description: Montana’s State Procurement Services Division is soliciting a vendor on behalf of the Department of Health and Human Services to provide utilization management and review services for the Montana Healthcare Program. The work includes level-of-care determinations, PASRR activities, functional assessments, prior authorizations, continued-stay reviews, eligibility determinations, and special-case reviews under applicable federal and state requirements and related policies. The selected organization must maintain QIO or QIO-like status throughout the contract period.
State · MT, US
Adjacent opportunities open for bidding right now.
Montana Department of Public Health and Human Services
State AgencyMT
Posted
Oct 21, 2026
Dec 8, 2026
Provide utilization management and review (UR) services, which include level of care determination, Preadmission Screening and Resident Review (PASRR) activities, functional assessments, prior authorizations, continued stay reviews, eligibility determinations, and special case reviews for the Montana Healthcare Program (MHP).
JPS Health Network, Purchasing Department
Special DistrictTX
Posted
Oct 28, 2026
Nov 3, 2026
Utilization Review Technology and Optimization Partner (URT). AI-enabled Utilization Management (UM) solution that integrates with Epic and related enterprise systems to support timely, consistent, and prioritized UM review across inpatient and observation encounters. The solution should analyze available clinical, utilization, payer, authorization, and encounter data to generate actionable, explainable recommendations for admission status review, continued-stay review, payer authorization needs, and physician advisor escalation. The goal is to improve review timeliness, status accuracy, regulatory compliance, revenue integrity, and throughput by moving UM workflows from primarily manual queue review to intelligent, risk-stratified prioritization.
Texas Health and Human Services Commission
State AgencyTX
Posted
Feb 1, 2025
Jan 31, 2028
Provide open enrollment for independent review organization services, medicaid & chip services, medical & UR appeals.
CountyIL
Posted
Oct 21, 2026
Nov 16, 2026
Consultant services for a facility optimization, utilization, and needs review, including a space needs assessment and capital plan development, for the McHenry County Division of Transportation's facilities.
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