Provider Data Management and Credentialing Verification Solution

The North Carolina Department of Health and Human Services, Division of Health Benefits, is seeking a cloud-based Provider Data Management and Credentialing Verification Organization solution with implementation, integration, migration, call center, and ongoing operations support.

State of North Carolina > Department of Health and Human Services > Division of Health Benefits


General
Closed (past due)
Doc2075995037
Sep 08, 2026 06:00 PM
Jun 12, 2026 02:30 PM
5 years base + 2 × 1 year options
Request for Proposal (RFP)
State
Ask AI about this solicitation
Contact
tyler.ragor@dhhs.nc.gov
+18882117440
Submission Instructions
Online
Proposal, Cost Proposal Workbook, One signed electronic copy, One redacted electronic copy
Description

The North Carolina Department of Health and Human Services, Division of Health Benefits, is soliciting proposals for a cloud-based Provider Data Management/Credentialing Verification Organization solution to support the Medicaid Integrated Modular Solution. The solution must centralize provider data throughout the provider life cycle, including data intake, management, enrollment, credentialing, data sharing, and archiving. It must support provider revalidation, delegated enrollment and credentialing, centralized credentialing for payers and health plans, a representative Credentialing Committee, provider directories, workflow automation, and alignment with National Committee for Quality Assurance standards. The solicitation requires vendors to demonstrate at least five years of combined experience providing similar PDM/CVO services to government agencies or corporate employers, with all cited experience occurring within the five years preceding issuance of the RFP. Addendum 6 revised and restated the minimum qualifications and requires the offeror to complete the revised Attachment Y, including detailed descriptions of relevant experience, populations served, periods of performance, and corresponding RFP requirements. Addenda 5 and 6 require executed copies to be returned with the proposal or before the proposal deadline.

Classification Codes
NAICS541513Computer Facilities Management Services
PSCAN45HEALTH SERVICES - OPERATIONAL SYSTEMS DEVELOPMENT
Smart Codes
provider data managementcredentialing verificationmedicaid enterprise system
Specifications
Supply & Service
No
Timeline
Jun 12, 2026-Posted Date
Jun 16, 2026 02:00 PM-Pre-Proposal Conference Registration Deadline
Jun 17, 2026 06:00 PM-Pre-Proposal Conference (optional)
Virtual Microsoft Teams conference; registration is required by emailing Medicaid.Procurement@dhhs.nc.gov.
Jun 26, 2026 06:00 PM-Written Questions Deadline
Jul 31, 2026-Agency Response to Written Questions / RFP Addendum Issued
Sep 08, 2026 06:00 PM-Proposal Due Date
Sep 14, 2026-Evaluation Begins
Jan 19, 2027-System Demonstrations
Jun 18, 2027-Estimated Contract Award
Requirements
Professional degree (e.g., MD, JD)
Required
  • Workers Compensation — $500,000.00
  • Employer's Liability — $500,000.00
  • Commercial General Liability — $2,000,000.00
  • Automobile Liability — $500,000.00
  • Uninsured/Underinsured Motorist — $500,000.00
  • Automobile Medical Payments — $5,000.00
Required
  • Minimum 3 references
  • Client point of contact required for each reference
Documents

Request 11 documents.

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