We created, formalized and executed the processes that allowed our client to successfully migrate to a core healthcare administration platform.

Challenge

The client needed to implement a custom-built, large-scale, healthcare administration platform for their Medicaid lines of business. To do so, they needed to develop new organizational processes and support practices. They also had to ensure the new system met formal compliance standards.

Solution

The engagement team created and defined the program structure, business requirements, design, testing and go-live support services. They developed processes to mitigate risk with the new platform and aligned the regulatory and organizational requirements to the future state model. To effectively manage all business units’ use of the new platform, the team established a governance structure to standardize processes, structured, implemented and optimized a UAT strategy, and supported the client through go-live and post go-live implementation activities.

Result

As a result, ProspHire enabled the organization to successfully migrate to the new healthcare administration platform within the desired timeline. The migration included rolling over all business units and achieving compliance with organizational and regulatory requirements. ProspHire also provided post-implementation support and developed a post go-live strategy, including job aids, desk level procedures (DLP) and change and release management governance models.

Outcomes

  • Successful system migration
  • Regulatory compliance
  • Standardized processes
  • Desk level procedures (DLP)
  • Risk mitigation
  • Go-live strategy
  • Post-implementation support

Client Overview

The client is a managed care organization (MCO) that provides health services to members within Pennsylvania. They have one of the largest Medicare programs and the largest D-SNP program in the state.

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Joshua Manning

Managing Director
Name

System Integration and Selection

Information Technology (IT) is the backbone of any enterprise and ProspHire is proficient at helping clients integrate and maximize their investment in infrastructure, enterprise architecture, information security, systems operations and support. We gather and translate system requirements, fully manage Request for Information (RFI) and Request for Proposal (RFP) processes and implement both custom and off-the-shelf solutions to achieve desired business outcomes.