Medicaid Physician Review and Consulting Services

Overview The Department of Vermont Health Access (DVHA) is soliciting proposals to contract with an actively licensed Physician(s) to provide medical oversight related to the clinical needs of the department, provide prior authorization case review and medical necessity determinations in a Medicaid Managed Care environment. In this environment the focus is not on limiting access to care or generating profits, but rather on being good stewards of public funds by ensuring that the care provided is medically necessary and cost efficient. Time Commitment The Contractor will provide consultative services on these activities, on an as needed basis, not to exceed ten (10) hours per week, according…