A large health insurance provider faced a significant challenge when their respective state announced a Medicaid expansion. To secure a bid for the expanded membership, the company needed to rapidly demonstrate its network adequacy and Medicaid service capabilities across the entire state. This required swift and effective outreach to healthcare providers throughout the region.
About the Client
- Largest health benefits provider in their respective state
- Serves more than 8 million customers
- Customer-owned health insurer for over eight decades
The Challenge
The state was undergoing a Medicaid expansion, and the client placed a bid on the membership. To secure the bid, the organization needed to demonstrate network adequacy and Medicaid service capabilities in all counties in the state.
The Solution
The client needed to get the word out fast by sending letters of intent to providers across the state. To accomplish this task, Medix worked with the client to bolster their provider relations team, including key management positions. Medix also recruited the network development and contracting staff who would work directly with providers to finalize contracts. In addition to these critical positions, Medix also placed administrative and clerical talent to address a variety of needs. On the backend, Medix ensured the client was prepared to take on care management and clinical support efforts by hiring skilled case managers and nurses.
The Results
The client ultimately won the Medicaid contract. Over the course of more than a year, Medix recruited and staffed over 200 individuals for the client within the following departments:
- Provider Relations
- Network Development
- Contracting
- Administrative and Clerical
- Customer Service
- Claims
- Case Management
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