RFP Consultant

Request for Proposal (RFP)

Consultant Opportunity – NCQA Health Plan Accreditation

Organization Summary:

Community Care Cooperative (C3) is a 501(c)(3) non-profit multi-service organization governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We fulfill two primary

business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.

We are a fast-growing, dynamic organization developing new partnerships and programs to

improve the health of members and communities, and to strengthen our health center partners. We have won “Best Places to Work” recognition from the Boston Globe for the last three consecutive years.

SCO and One Care Summary:

The Senior Care Options (SCO) and One Care programs are health plan programs for dually eligible (Medicare and Medicaid) individuals (“duals”) in Massachusetts. SCO serves eligible beneficiaries aged 65 , while One Care serves duals between ages 21-64. These programs are fully integrated dual-eligible special needs plans (FIDE-SNP) that integrate Medicare and Medicaid benefits, along with additional support for enrollees such as integrated care teams, care managers, social supports, etc.

Massachusetts’ Medicaid agency recently conducted a procurement for health plans to offer products in these two programs, for a five-year term starting January 1, 2026. C3 submitted a bid and was selected in September 2024.

Scope of Work:

C3, an ACO dedicated to providing comprehensive and equitable healthcare services, invites qualified consultants to submit proposals to lead C3’s National Committee for Quality Assurance (NCQA) Health Plan Accreditation process. The consultant will provide technical expertise, project management, and coordination of activities to achieve full accreditation by the applicable dates. Duties include, but are not limited to managing the development, implementation, and evaluation of policies, practices, and workflows for compliance with NCQA standards across all C3 departments, as well as the submission of all accreditation documents. Achieving NCQA Health Plan Accreditation fulfills an important obligation as we establish our capabilities as a Health Plan.

Technical Expertise:

• The consultant will serve as the subject matter expert on the 2025 NCQA Health Plan Accreditation Standards and their interpretation.

Project Management:

• The consultant will:
  • Coordinate and facilitate meetings with the relevant stakeholders (internal C3 departments, FQHC staff, external vendors, etc.) necessary to achieve NCQA compliance (purpose of meetings can include: co-creation of project plan, survey implementation, consulting patients, etc.)
  • Create, track, and communicate relevant timelines for fulfillment of each standard, taking into account the relevant look-back periods assigned by NCQA
  • Ensure that each stakeholder does their part to maintain progress toward full achievement of each NCQA standard
  • Update and maintain the check list/gap list for each department to reflect their progress toward fulfillment
  • Draft, edit, review, and approve policies, Standard Operating Procedures (SOPs), reports, Memorandums of Understanding (MOUs), contracts, narratives, and other documents for NCQA compliance
  • Communicate with NCQA regarding any questions or issues that come up, for example, questions related to the interpretation of the standards

Submission:

• The consultant will prepare all documents for submission to NCQA in advance of the relevant deadline for each standard
• Respond to any post-submission requests from NCQA for clarification/resubmission of documents or submission of additional information

Timeline:

We anticipate that the consultant’s role in C3’s NCQA accreditation process will span the time period of January 1, 2025 – December 31, 2025. The timeline may be expanded depending on requirements.

Proposal Submission:

Interested consultants are requested to submit a proposal including the following components:

• Detailed overview of relevant experience in helping organizations to achieve NCQA Health Plan Accreditation
• Clear project management approach and methodology
• Proposed project schedule and timeline
• Budget breakdown, encompassing consulting fees and associated costs

Selection Criteria:

The consultant will be selected based on the following criteria:

• Proven expertise in guiding healthcare organizations through the process of achieving accreditation
• Relevance of the proposed project management approach
• Proposed budget's alignment with project scope and objectives

Contact Information:

Please submit proposals by December 31st to:

Ben Janelli

Senior Director of Compliance and Contract Management

Community Care Cooperative (C3)

bjanelli@c3cao.org

** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **