Welcome to ProspHire’s Medicaid Practice, where we bring specialized, innovative solutions to health plans and providers navigating the complex Medicaid landscape. Focused on enhancing quality of care and optimizing cost management, our Medicaid experts partner with your team to address pressing issues like health disparities, regulatory compliance and efficient resource management. Through a combination of strategic insights and industry expertise, ProspHire enables Medicaid organizations to elevate their service delivery and optimize program effectiveness.
Driving Lasting Impact for Medicaid Programs
ProspHire’s Medicaid Practice delivers solutions that drive quality improvement, streamline workflows and improve financial performance. Our clients benefit from:
- Enhanced Care Delivery and Member Satisfaction: By optimizing care coordination and addressing health disparities, we help clients create more inclusive, responsive Medicaid programs that improve patient outcomes and satisfaction.
- Regulatory Compliance and Performance: With specialized support in HEDIS optimization and NCQA accreditation, ProspHire helps clients stay compliant with Medicaid regulations, allowing them to avoid costly penalties while demonstrating a commitment to excellence.
- Operational Efficiency and Cost Savings: Our customized approaches to integrated care (SNP alignment, MLTSS), system integration and process optimization reduce administrative burdens, enabling organizations to redirect resources toward meaningful patient care and strategic growth.
Partner with ProspHire for Medicaid Success
ProspHire is more than a consulting firm—we are a strategic partner dedicated to your Medicaid program’s success. Our tailored solutions reflect our deep understanding of Medicaid’s complexities, empowering clients to adapt to evolving challenges while prioritizing quality care and efficient cost management. With ProspHire’s guidance, Medicaid organizations can transform their approach to healthcare delivery, drive measurable improvements and build a sustainable future.
transforming medicaid
elevating care, reducing costs with prospHire
Discover how ProspHire’s innovative solutions can help your organization improve patient outcomes, address health disparities and optimize cost management—especially in Medicaid. From strategic planning and maternal health equity initiatives to HEDIS performance and risk adjustment, our expert team is here to guide you every step of the way.
How ProspHire Can Help
See how ProspHire can help address the key issues facing your organization.
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Medicaid and MLTSS Programs and Operations
ProspHire partners with health plans to optimize Medicaid and Managed Long-Term Services and Supports (MLTSS) programs. We assess operational performance, streamline service delivery and implement sustainable improvements to drive compliance, member satisfaction and improved health outcomes.
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MCO State Planning and Implementation
From opportunity assessment to go-live, ProspHire supports Managed Care Organizations (MCOs) through every phase of state planning and implementation. We align strategy with state-specific requirements to ensure a compliant, competitive and member-focused launch.
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Operational Audit Readiness
Accreditations, regulations and operational compliance are tedious and continuously under the microscope. ProspHire supports health plans through documentation, review and readiness to be audit-ready in the face of current, future or anticipated review.
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Quality Program Transformation
ProspHire drives transformation of Medicaid quality programs through analytics, redesign and performance improvement initiatives. We help organizations elevate care delivery, close quality gaps and achieve higher ratings across quality measures.
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Medicaid Program and Operations Innovation
Reimagine Medicaid operations with ProspHire’s innovation-focused approach. We assess existing workflows, introduce automation and digital solutions and implement forward-thinking strategies that enhance efficiency, cost of care and organizational outcomes.
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Special Needs Program Integration
ProspHire helps plans integrate Special Needs Programs (SNPs) seamlessly into Medicaid operations to achieve Highly and Fully-Integrated status. We help you from roadmap development through execution to stay compliant and operationally lean by managing regulatory requirements, streamlining operational functions, and optimizing care management functions.
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Govt Markets Required Documentation
ProspHire supports the timely and accurate submission of required documentation for participation in government-sponsored programs. Our team helps manage deadlines, align content with regulatory expectations and reduce the risk of non-compliance, keeping your organization audit-ready and on track.
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Client Results
