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.

Graphic of Maximus Provider ConneXion and its four features: Medicaid Provider Enrollment, Centralized Credentialing, Medicaid Provider Portal, and Reporting

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
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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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Modernize and transform your MMIS

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Medicaid member and provider experiences

State and local government solutions

Across all 50 states and D.C., we help agencies accelerate service delivery to address challenges and move people forward.

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