Medicaid Enterprise Services
Medicaid programs are complex and vital. We help states improve member and provider experiences, modernize capabilities, and increase access to care.
Focus on member and provider experience
As states modernize their Medicaid enterprise, focusing on member and provider experiences helps align solutions with program goals. Prioritizing delivery and balancing modernization with modularity can enhance engagement, streamline operations, cut costs, and improve care.
Elevated provider experience
Maximus Provider ConneXion® (MPC) simplifies enrollment, credentialing, and reporting, and offers a self-service portal for claims, prior authorizations, appeals, and eligibility.
Tailored application process
Administrators can manage multiple providers under a single account, with provider-specific visibility.
Robust reporting
Our MPC reporting module offers insights into enrollment, application tracking, credentialing stages, provider adequacy, license renewals, site visit aging, and trends.
Multiple security layers
Our built-in security mechanisms comply with federal architecture guidelines and standards, including the National Institute of Standards and Technology (NIST).
Data integrity maintenance
MPC uses a flexible data model to automate feeds and ensure provider data integrity with real-time or daily updates. We help to define, configure, and optimize initial data.
Enhancing the experience for providers and members
Targeted modularity and modernization help Medicaid programs optimize solutions to support their mission. A flexible, integrated system offers data insights, agility, streamlined operations, and better user experiences. When modernizing your MMIS, explore these considerations:
- Prioritize functions aligned with goals
- Identify program challenges and risks
- Plan the delivery, integration, and quality assurance
- Focus on user experiences
- Remember the data strategy
Broad Medicaid expertise
Simplifying eligibility and enrollment
For decades, we’ve helped Medicaid agencies engage and connect individuals to essential program benefits. Accessing government services should be easy and convenient, with programs that are accurate, user-friendly, and efficient. Our streamlined approach engages people through their preferred channels and then connects them to the right benefits and services more quickly.
Delivering comprehensive clinical assessments
As the leading provider of specialized screening and assessments for government programs, our assessment solutions and services span the full spectrum of long-term services and supports (LTSS). Our clinical platform solution hosts a variety of screening and assessment tools to support all populations and program reporting services, enrollment broker, and eligibility operations.
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Making an impact: Meet Donna Migoni
As Executive Managing Director of Medicaid Enterprise Services, Donna knows that Medicaid is an essential lifeline for millions of people. She’s devoted to reshaping service delivery to create smooth, empathetic experiences at every touchpoint, helping states achieve their goal of improved health and wellbeing for the people they serve.
See Donna's impact