Medicaid HEDIS Optimization

Aligning Goals, Data and Action for Sustainable Success

Population health management, vendor optimization, data infrastructure and provider engagement are at the forefront of enhancing HEDIS performance. HEDIS measures play a significant role within the industry calling for enhanced gap closure and decreased costs of associated care through preventative services. To track progress, ProspHire leverages HEDIS data to drive decision making and prioritized action planning.

At ProspHire, we seek to align organizational Medicaid goals with industry requirements. By building and formulating a foundational model aimed to drive performance and align resources across partnering services, ProspHire supports clients in developing and executing a sustainable HEDIS program.

Key Contacts

Rebecca Luketich

Senior Manager
Email | Full Bio

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How ProspHire Can Help

See how ProspHire can help address the key issues facing your organization.

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    Measure Gap Assessment & Future State Roadmap

    Assess current state to inform and design future state processes, leading to improved data management and reporting.

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    Organizational Governance Model

    Build and formulate an industry standard Medicaid Governance Model aimed to drive performance, optimize resources and align foundational levers with partnering Lines of Business.

  • Community-Based Partnership Development

    Practice the Medical Neighborhood Model to increase referrals, assess utilization and optimize community engagement opportunities to improve access.

  • Dashboard Optimization

    Transform Medicaid data through dashboarding to inform operational and strategic decision making.

  • Medicaid Audit Execution & Regulatory Body Compliance

    Manage the planning, execution and reporting of NCQA / CMS regulatory reporting bodies.

Client Results

Enhancing Dental Practice Management

Dental Revenue Cycle Management Centralization

Dental Management Revenue Cycle Management

Dental Practice Management System Optimization

Streamline Implant Workflow

Dental Practice Management System Conversion

Dental Practice Management Workflow Redesign