At ProspHire, we understand that navigating the complexities of Medicare Advantage can be a challenge. Our Medicare Advantage Practice team provides expert guidance and strategic support to help health plans optimize their operations, maximize revenue and drive better outcomes for beneficiaries.
With a comprehensive range of services, from strategy to execution, we partner with health plans to design, build, and optimize every aspect of their Medicare Advantage business. Whether it’s product design, market expansion, revenue optimization, Stars and quality improvement, operational transformation, or regulatory compliance, our consultants bring both the industry knowledge and the hands-on experience to deliver measurable impact.
We are trusted advisors and execution partners to some of the nation’s leading health plans. If your organization is looking to grow membership, navigate regulatory change, or build the next generation of MA capabilities, ProspHire is your trusted partner to help you succeed.
Why Choose ProspHire for Medicare Advantage Assistance?
At ProspHire, we understand that Medicare Advantage is a dynamic and highly regulated space where health plans must balance quality outcomes, financial performance, and member satisfaction. The program continues to evolve rapidly, with growing regulatory pressures, emerging technologies upending the status quo, and challenging financial realities to navigate.
Our Medicare Advantage Practice helps health plans navigate these complexities with confidence. From market development to revenue optimization to operational effectiveness, we work closely with our clients to evaluate and transform their Medicare Advantage programs. Our team’s deep expertise across the spectrum of Medicare Advantage ensures that health plans can anticipate market shifts, respond to regulatory changes and optimize strategies that drive measurable results.
We recognize that every plan is unique. That’s why we take a tailored, data-driven approach to support operational efficiency, enhance member experiences, and achieve sustainable growth.
The Medicare Advantage reset is here, and the new normal demands both regulatory fluency and operational excellence. At ProspHire, we combine deep expertise in CMS rules and requirements with a proven track record of building practical, high-performing operating models. With ProspHire as your partner, you’ll have the clarity, strategy, and execution support needed to navigate this reset with confidence and achieve sustainable success in Medicare Advantage.
Partnering with ProspHire Means
- Navigating the complexities of Medicare Advantage with expert guidance
- Driving measurable improvements in quality and performance
- Strengthening alignment between operational strategies and member outcomes
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Building sustainable growth in an increasingly competitive landscape
At ProspHire, we don’t just help Medicare Advantage plans keep pace with change, we help them lead in Medicare Advantage’s new era.
How ProspHire Can Help
See how ProspHire can help address the key issues facing your organization.
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Medicare Product Go To Market Development
ProspHire helps health plans develop and execute go-to-market strategies for Medicare products, ensuring they meet beneficiary needs, drive growth, and exceed organizational goals.
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Medicare Revenue Optimization
We optimize Medicare revenue through improved risk adjustment, administrative savings, bid and pricing strategies and enrollment processes to enhance financial performance and member care.
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Medicare Operational Effectiveness
We streamline Medicare processes to reduce administrative burdens, optimize workflows and ensure high-quality care while maintaining cost control.
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Medicare Operating Model Evaluation and Development
ProspHire helps develop efficient, scalable operating models that support sustainable growth and adapt to market changes in Medicare specifically tailored to your organization.
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Medicare/Medicaid Integration and Alignment
We assist health plans in navigating their DSNP alignment requirements at the state and federal level, enabling not only compliancy but also optimizing market performance and member satisfaction.
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Stars Advisory and Consulting Services
ProspHire offers strategic expertise and insights to help health plans improve Star ratings and achieve better performance in quality measures, by successfully navigating a complex and evolving regulatory landscape.
