The Nautilus Plan Administrator (TPA)
Procurement, Contracting & Management Project

A signature Nautilus initiative, our TPA Project has been meticulously crafted with a singular purpose: to equip mission-aligned healthcare purchasers with the essential tools, insights, and strategies required to navigate the intricate landscape of the TPA relationship successfully.

Our field guide aims to empower, educate, promote compliance, enhance transparency, and optimize outcomes — all to strengthen the impact

From Why to How — and All the Way to Done

Our guide will empower you with the knowledge and expertise to excel in the world of TPA management.

Contract Smarter. Procure Better. Make an Impact.

Our tools aim to empower, educate, promote compliance, and enhance transparency.

CORE TOOLS

  • Model Contract Language

  • Model Data Agreement

  • Key Issues Review Checklist

  • RFP Questions List

BATTLE-TESTED TEMPLATES

  • RFQ & RFP Samples

  • Notices for Procurement Process

  • Data Demand Letters

  • Key Requirements and Objectives

REFERENCE MATERIAL

  • Compliance Guide about Gag Clause

  • Vendor Selection Webinar

  • White Papers & Case Studies

  • TPA Glossary

No Matter Your Role, We’ve Got You Covered.

If you’re ready to take your TPA management to new heights, you’re in the right place.

WHO IS THIS FOR?

Broker/consultants: gain comprehensive insights for both seasoned professionals and newcomers seeking to enter the field

HR professionals and insurance experts: find practical recommendations to better serve their clients.

Compliance officers: learn to navigate can the complex regulatory landscape, including laws like the Gag Clause Prohibition.

Healthcare administrators within TPAs: develop a deeper understanding of your roles and responsibilities.

Legal professionals specializing in healthcare or contract law: stay updated on relevant regulations and negotiation strategies.

Employers and plan sponsors: get accessible information when selecting medical claim administrators and overseeing employee benefit plans.

WHAT’S IN THE GUIDE?

Five key phases: our guide walks you through the five key phases of the TPA vendor selection and management, including preparing for and conducting an effective vendor selection process, as well as contracting with, onboarding, and monitoring and evaluating your selected vendor.

Effectively access and use data: you’ll learn about the best practices for data management, helping you leverage data for decision-making and optimizing TPA services, as well as data security and privacy to ensure compliance.

Critical additional knowledge: gain insights into emerging trends, technological advancements, and regulatory changes, review resources for continuous improvement in TPA procurement, and explore some common myths and truths surrounding TPA procurement, contracting, and other processes.

Templates: You’ll get instant access to customizable templates, from sample contracts and clauses to checklists and RFP questions.

Meet the Contributors

Amy LeVrier

Contact us to become a project contributor.
Join us — and be recognized as a leader in our movement.

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