Services

ProspHire’s team of clinicians help organizations optimize processes to improve health outcomes. We have deep subject matter expertise in care management (CM), utilization management (UM), value-based care (VBC), social determinants of health (SDOH) and population health reporting. We are adept at addressing patient experience challenges, throughput optimization and clinical resource management. Our demonstrated results lead to increased profit, enhanced operational efficiency, improved clinical outcomes and a better patient and provider experience.

ProspHire is adept at driving continuous improvement to optimize Stars performance. Through data driven analyses and clearly defined strategies, our team of seasoned subject matter experts implement interventions to increase Stars ratings and maximize rebate potential.

ProspHire has expertise in supporting organizations across the spectrum of internal and external growth. From optimizing internal capabilities to leading mergers and acquisitions, we partner with clients to create strategies that reflect their current landscape and develop a clear roadmap to get where they want to be. We help organizations drive and sustain transformative change by connecting strategic priorities to action.

ProspHire’s team of seasoned healthcare professionals helps organizations update, expand, launch or retire their Plan Benefit Packages (PBPs). From strategic planning to implementation, we provide the support they need to optimize their benefits offerings, meet Centers for Medicare & Medicaid Services (CMS) deadlines and ensure compliance. Our structured and sustainable approach drives successful outcomes, and our member-centric strategies improve engagement and retention.

Regulatory requirements are constantly changing and ProspHire helps clients ensure their government programs are compliant, efficient and effective. The Firm specializes in optimizing operations and managing the production and distribution of Centers for Medicare & Medicaid Services (CMS) required documents.

ProspHire manages the complexities of large-scale programs and allows clients to run their business. Our seasoned program and project managers (many of whom are PMP-certified) oversee and execute programs using a myriad of project management methodologies (Waterfall, Agile, Six Sigma, Scrum, Hybrid, etc.) to drive results.

Disciplined Vendor Management Office (VMO) operations are critical to the growth, financial health and the mission of providing quality care to members. Health plans are positioned to recognize significant cost savings and efficiency creation opportunities by establishing, fully integrating and optimizing VMOs.

ProspHire drives in-depth analyses and recommends strategies to help organizations operationalize their VMO. Our custom tools help streamline the vendor selection and onboarding processes, and the efficiency measures we put in place will help any organization realize real cost savings.

ProspHire assesses business processes to identify strengths and weaknesses, address performance issues and improve efficiency across a business unit or the entire organization. Our analyses and recommendations improve resource utilization and help create a culture of continuous improvement.

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.

Finding the right people for the right roles can be challenging, particularly when the need is urgent. ProspHire has the bench strength you need to fill interim executive roles, fully staff departments and everything in between. We provide the right resources with the right skills to get the job done.