The California Health Benefit Exchange (the Exchange) needs to assist millions of Californians understand the coverage and enrollment options that will become available effective 2014, and enroll in the program that is right for them. One of the core functions to support this eligibility and enrollment process with be the “service center” functions of assisting individuals who call with questions and need assistance with the web-based enrollment system. As the Exchange develops options for providing services, it is working closely with the Department of Health Care Services (DHCS), the Managed Risk Medical Insurance Board (MRMIB) and other parts of the state, as well as public and private sector partners throughout the state in this planning process.
Purpose of Contracting with Service Center Consultant (Solicitation HBEX9)
The California Health Benefit Exchange is seeking the assistance of a consultant, under the direction of the Exchange, to plan for setting up and managing a service center. This will include providing strategic and tactical support for the Exchange in developing and assessing alternative approaches for servicing callers who seek information or wish to enroll in new coverage options starting Summer 2013, as well as approaches for providing other services such as incoming mail handling, payment processing, and outgoing communications. The work will also include preparation of solicitation documents required under the chosen approach. The Exchange hopes to select a consultant/vendor by June 12, 2012, with work to begin immediately and services to be provided through the Fall of 2012.
Statement of Work
The consultant is expected to assist in the development of strategic planning and provide tactical support in the development and establishing of a Service Center to include the following areas:
- Options for use of Telephony/IVR and switching technologies
- Technology, management and cost issues regarding use of single service center and/or central service center with multiple additional sites of service (potentially operating with different contracts)
- Evaluation of the steps to achieve integration of existing with new technologies for optimal multicenter service to consumers
- Capacity planning and management of high initial peak volumes (e.g. during open enrollment period from July 2013 through March 2014) versus ongoing volumes
- Management of initial uncertainty of service volumes
- Assistance with estimating call/service volumes and types, and developing associated staffing plans
- Development of processes to assure timely consumer-centric service
- Development and support for conducting a solicitation for providing Service Center functionality
Additional information on the scope of the solicitation, timing and work expected from the consultant can be found at www.healthexchange.ca.gov
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