New York State Department Of Health

Buyer seeks a contractor to provide enrollment broker services for New York State's Medicaid managed care programs. Services include processing enrollments/disenrollments, operating a statewide HelpLine, conducting outreach and education, developing materials, managing exemptions/exclusions, and maintaining data systems. The contractor will staff local offices to provide in-person assistance and coordinate with health plans and state agencies. The contract term is for 5 years starting April 2026.

• 2/27/2025 - Questions Due
• 3/18/2025 - Responses to Questions Posted
• 4/11/2025 - Proposal Due Date
• 4/1/2026 - Anticipated Contract Start Date

• 5 years experience performing Enrollment Broker services for Medicaid program with 500,000+ beneficiaries
• 5 years experience providing Call Center support for 500,000+ Medicaid population
• 5 years experience performing Managed Care Enrollment for 1,000,000+ population
• 5 years experience operating high-volume customer service call center (15,000+ calls/day)

• Process enrollments/disenrollments for Medicaid managed care programs
• Operate statewide toll-free HelpLine to provide information and assistance
• Conduct outreach and education activities on managed care options
• Develop and distribute program materials and notices
• Manage exemption and exclusion requests
• Perform auto-assignments to health plans
• Maintain data systems and generate reports
• Provide quality assurance and complaint resolution
• Staff local district offices for in-person assistance
• Coordinate with health plans and state agencies