Medicaid
Maximus helps states connect people to coverage and care through technology-enabled eligibility and enrollment solutions, community outreach and engagement, clinical services, and provider support.
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We help states navigate change, increase efficiencies, reduce administrative burdens, and enhance member and provider experiences.
What makes Maximus a trusted partner?
- The largest administrator of Medicaid support services in the country
- A leading contact center provider with 100+ contracts
- A vendor that consistently achieves high customer satisfaction ratings from state agencies
How we're helping states meet Medicaid community engagement requirements
As community engagement and work requirements reshape Medicaid, states need a trusted partner who can translate complex mandates into clear, workable solutions.
With decades of experience, advanced technology, and proven operational expertise, we can help states stay compliant, reduce administrative burden, and maintain coverage for eligible members.
Key to our approach is empowering members with simple, accessible tools that make it easier to meet the requirements, pursue employment, and improve their overall health and wellbeing.
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A complete solution for community engagement
Our community engagement solution combines advanced technology with wrap‑around services and customer service support. Designed especially for cases where data matching alone isn’t enough, it integrates smoothly with existing state Medicaid systems and third‑party partners.
We’re dedicated to helping states successfully implement new Medicaid requirements through cost-saving, supportive solutions.
Read the CMS announcementMobile‑first, self‑service portal
At the center of our solution is a mobile‑first, self‑service portal where members can easily report activity hours, request exemptions, and upload documentation directly from any device. States can electronically verify information with employers or community organizations to reduce fraud, waste, and abuse.
The portal also offers a job board to help members search for employment opportunities and a digital health risk assessment that identifies the health and social supports they may need to enter the workforce or engage in community activities.
Comprehensive services to help states meet new requirements
Members can easily and securely report and verify their Community Engagement activity.
- AI‑enabled contact center with self‑service IVR handles peak call volumes
- Mobile‑friendly portal and app support reporting, exemptions, and job search
- Reporting tools for state compliance
- Targeted outreach to educate members
Our proactive outreach and education deliver accurate, easy‑to‑understand guidance across multiple channels.
- Outbound calls, texts, and mail campaigns
- Customer support for questions and general information
- Back‑office and mailroom services
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We put your members first with modern, AI-enabled contact center solutions that boost efficiency, accuracy, and support.
- Member-centered tools across self-service IVR, web, mobile apps, text, email, and virtual assistants
- Inbound/outbound calls and chat
- Quality management
We streamline appeals processing for faster, more accurate outcomes that avoid unnecessary coverage gaps.
- Identify roadblocks and streamline workflows
- Scalable appeals intake and processing support
- Preparation of appeals files aligned with state policy
Discover our tech-driven Medicaid solutions
Simplified eligibility and enrollment
Streamlined application and enrollment processes enhance operational efficiency and strengthen customer engagement.
View our Medicaid case studies
AI for improved government CX
Discover how we use advanced technology to improve the quality assurance process at a large customer contact center for Michigan's Medicaid program.
View the Michigan case study
Stronger provider networks
See how our support for Medicaid centralized credentialing in Ohio streamlined provider enrollments, improved data accuracy, and enhanced care access.
View the Ohio case study
Access to home and community-based care
Learn how we expedited a complicated waiver application process from 90 to 30 days, helping older adults and people with disabilities access services and supports.
View the Pennsylvania case studyExplore our Medicaid perspectives
Medicaid FAQs
Maximus operates as a conflict‑free partner with no ties to health plans, providers, or payers. We deliver unbiased choice counseling to help Medicaid members select managed care plans that meet their needs. We provide objective, independent clinical assessments that help people and their caregivers navigate paths to services and supports.
Maximus provides clear guidance and easy‑to‑use tools that help participants understand what’s required and what activities qualify. Mobile‑friendly portals allow participants to report activity hours, request exemptions, and upload documentation securely, reducing confusion and administrative burden while helping them stay compliant.
Maximus supports provider network quality by simplifying onboarding, credentialing, and revalidation processes. Streamlined workflows reduce administrative friction, helping states attract new providers and retain existing ones — especially in underserved or high‑demand areas.
Maximus conducts PASRR Level I screenings and Level II clinical evaluations for individuals with serious mental illness, intellectual disability, or related condition — helping states comply with Centers for Medicare & Medicaid Services requirements and protect populations with complex needs.
