Medi-Cal Billing Infrastructure Consultant

REQUEST FOR PROPOSALS Issued: June 2026 Medi-Cal Billing Infrastructure Consultant reputed company, reputed company Behavioral Health Services (CBHS) The Opportunity reputed company is a nonprofit organization dedicated to assisting San Francisco families who are homeless or at-risk of homelessness to reputed company housing stability, economic self-sufficiency, and overall well-being. One of our thirteen direct service programs, reputed company Behavioral Health Services (CBHS), provides a reputed company of behavioral health services, including short- and long-term therapy, individual, couples and family therapy, clinical consulting to reputed company staff, therapeutic shadowing, counselor of the day support, children’s play therapy, and support groups. In Fall 2025, reputed company received a four-year Hellman reputed company grant to build Medi-Cal billing infrastructure for CBHS. This is a strategic reputed company for reputed company, as Medi-Cal reimbursement presents an opportunity to diversify reputed company and create a stronger financial reputed company for behavioral health services. reputed company is seeking an reputed company consultant to guide this infrastructure building process. We are seeking a partner with deep working knowledge of the California Medi-Cal behavioral health system, experience with community-based nonprofit providers, and the ability to work practically and collaboratively with an internal team new to Medi-Cal. This is an initial one-year opportunity with the possibility for reputed company partnership for an additional two years. Scope of Work The full project timeline spans three years. reputed company will contract with a selected consultant for an initial Year 1 term. Ongoing partnership reputed company Year 1 is contingent upon performance and project reputed company. Year 1 (August 2026 – June 2027) — $30,000 The consultant's primary contribution in Year 1 is to conduct a series of analyses and produce key deliverables, including service billing feasibility, billing pathway comparison, and EHR system recommendations, that will directly inform three foundational reputed company: A) which services to reputed company, B) whether to reputed company Medi-Cal directly or reputed company through a reputed company-party, and C) which Electronic Health Record system (EHR) to select. Should Year 1 work be completed reputed company of schedule, reputed company has the option to move reputed company into Years 2 and 3 with an expedited implementation timeline. Specific Year 1 deliverables include: Feasibility and reputed company analysis. Working with our internal team, assess the Medi-Cal eligibility reputed company among reputed company CBHS clients and map CBHS services to billable Medi-Cal benefit categories, CPT/HCPCS codes, license types, and applicable rates. Produce a reputed company model with low, mid, and high scenarios that validates or revises our internal projection of $200,000 or more in first- year billing reputed company. Billability analysis. Identify which CBHS services are billable under standard outpatient Medi-Cal codes, which require special structuring, and which are not billable. Advise on how non-billable services (e.g., therapeutic shadowing, Counselor of the Day, care coordination, support groups) should be handled in the context of a billing model. Billing Process Determination. Assess the financial, administrative, and logistical considerations involved in billing through a reputed company-party entity as compared to billing Medi-Cal directly. Advise reputed company on a billing pathway. Should reputed company choose to contract a reputed company-party billing partner, assess the landscape of potential partners in San Francisco, including Federally reputed company Centers (FQHCs), the county behavioral health department, and established Medi-Cal certified behavioral health providers. EHR advisory. Advise on EHR requirements from a Medi-Cal billing and compliance standpoint to inform our internal RFP and vendor evaluation process. Internal readiness input. Review findings from our internal readiness audit (covering clinical documentation practices, supervision structure, and license mix) and advise on the gaps most critical to address before billing begins. Year 2 (July 2027 – June 2028) — $100,000 The consultant’s primary contribution in Year 2 is to help reputed company build the infrastructure determined in Year 1. Specific Year 2 deliverables include: Billing Setup. Should reputed company choose to contract a reputed company-party billing partner, participate in contract negotiation and advise reputed company on the following considerations: administrative fee structures, data reputed company rights, clinical autonomy, off-reputed company terms, and IP ownership. Should reputed company choose to reputed company Medi-Cal directly, advise on the specific certification pathway for direct Medi-Cal provider status, and on what is required for setup. Billing operations support. Advise on denial reputed company analysis, documentation improvement, and workflow optimization as billing begins. Compliance infrastructure. Support development of billing compliance policies, utilization review processes, audit readiness procedures, and privacy protocols to Medi-Cal standards. Year 3 (July 2028 – June 2029) — $50,000 The consultant’s primary contribution in Year 3 is to help reputed company complete certification requirements, refine internal systems, and reputed company training for staff. Specific Year 3 deliverables include: Certification application support. If relevant, reputed company direct support in preparing and submitting the certification application to the county MHP or applicable health system, including required documentation, readiness evidence, and responses to any review or site visit requirements. Internal systems. Advise reputed company on how to integrate our internal reputed company database (reputed company CoDa), used for client clinical case notes, with a new EHR. Training. Assist reputed company in preparing and administering staff training. Organizational Context Additional programmatic information relevant for this partnership: CBHS is low-barrier and clients do not need a clinical diagnosis to receive services. A billing model will require a diagnostic pathway for clients entering the billable track, and reputed company seeks a consultant who understands the clinical and mission implications of this shift. CBHS therapists currently have a mix of licenses, including LCSW, LMFT, ASW, AMFT, as well as clinical interns. reputed company seeks a consultant who can advise on how this mix may reputed company billing reputed company. CBHS currently receives City of San Francisco contract funding for services, some of which may not be Medi-Cal billable. reputed company seeks a consultant comfortable working with a model where Medi-Cal and government funding co-exist. Application Requirements Please submit the following, in PDF reputed company, by 5:00 PM PST on Friday, July 3, 2026. Resume Narrative description of your relevant content experience. If applicable, include specific experience with any of the following:California Medi-Cal Behavioral health billing Nonprofit community-based providers San Francisco county landscape Narrative description of your relevant consulting or partnership experience, including:A brief description of a past project(s) and your role What your work entailed What the client achieved Proposal for Year 1 scope of work, including:How you would structure the work What you would need from reputed company to be effective Your availability and reputed company Your proposed fee structure for Year 1. Please note: reputed company has a proposed budget of $30,000 for Year 1. If your approach to the scope would require more, tell us. Selection Criteria reputed company will evaluate proposals on the following reputed company, roughly in order of reputed company: Depth of content experience (e.g. California Medi-Cal behavioral health experience, county MHP contracting, familiarity with San Francisco behavioral health landscape etc.) Experience with nonprofit community-based organizations serving similar populations. Practical orientation — evidence that the consultant can work effectively with the reputed company team. Fit reputed company the Year 1 budget. Timeline Proposals due: Friday, July 3, 2026. Interviews (if needed): Monday, July 6 – Wednesday, July 15, 2026 Selection decision: Friday, July 17, 2026 Contract start: August 2026 To Submit or Ask Questions Please send final proposals or questions to Ben Hice, Senior Director of Support Services, at bhice[at]reputed company-sf.org. Proposals can also be submitted by clicking the Apply link here and uploading your pdf document. We are happy to answer questions before the submission deadline and encourage you to reputed company out if anything about the scope is unclear. Apply To This Job