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Module meets the Centers for Medicare & Medicaid Services’ requirements for Medicaid providers and improves access and quality of care for members.

We've announced that our state client, the Ohio Department of Medicaid, has received streamlined modular certification for the provider network management module of its Medicaid Enterprise System (MES) by the Centers for Medicare & Medicaid Services (CMS). Maximus has supported the department since 2019, including the launch of its online portal for Medicaid providers.

The streamlined modular certification is a significant milestone as it recognizes efforts to enhance the experience of Medicaid providers across the state and is a required process for states to receive additional funds from the federal government. In addition to Ohio, Maximus has supported MES provider module certifications for Nebraska and Washington, D.C.

“As many states embrace better provider and member experiences through their MES vendor partnerships, Maximus delivers increased self-service options, the elimination of paper-based agreements, and an additional layer of security through single sign-on. This is critical as states need more qualified providers to meet the diverse needs of Medicaid members, particularly those residing in underserved locations,” said Donna Migoni, Executive Managing Director, Medicaid Enterprise Services, Maximus. “Supporting our state clients through their modernization efforts and certification process is a complex undertaking. We’re proud to be part of Ohio’s Medicaid program.”

The Ohio Department of Medicaid and Maximus partnered for the design, development, and implementation of the provider network module, which also includes the online provider portal, as the official source of provider data for the state’s Medicaid program. Maximus brought MES technical expertise and experience to establish and maintain efficient workflows and seamless integration.

Today, the online provider portal offers a one-stop, streamlined enrollment workflow that also includes centralized credentialing. Providers use this self-service platform, which allows for the accurate, timely, and secure exchange of data with the state Medicaid agency and Ohio’s Medicaid Managed Care Organizations (MCOs), rather than having to credential with each MCO. By removing administrative obstacles, providers can focus more on care delivery.

In Ohio, there are currently more than 217,000 active providers in the online portal, with more than 33,000 new providers enrolled in the past year. The response from providers has been overwhelmingly positive with the portal and its technology. Maximus continues to assist providers with inquiries and manage the production support updates made to the Ohio provider module.

To learn more about Maximus and its work with states to improve the provider experience, visit: maximus.com/solutions/provider-management-services.