Government Programs Consulting
Expert consulting services for TPAs, payers, and providers that want to launch or expand Medicare, Medicaid, Special Needs Plans, and Medicare Advantage lines of business.
Engageour Medicaid and Medicare Consultants
Comprehensive services to guide strategy, operations, and best practices
We offer both Medicaid consultant and Medicare consultant services to support your selection of the right plans and how to implement them successfully. Plus, we can support operations with interim staffing, training, and best practices.
Consulting services to support complex processes
Engage our consultants to write policies and procedures, and training to handle enrollment, customer service, appeals and grievances, training, and implementation for all types of Medicare and Medicaid plans.
Leverage our expertise to maintain compliance and achieve recognized excellence
Maintain regulatory compliance and prepare for audits with ease through our Medicare and Medicaid consulting services. Our consultants can help you improve your STAR ratings with comprehensive strategies and analytics. We also do mock audits, remediation support and validation audits.
What’s Included in Government Programs Consulting
Medicare Advantage and Medicare Consulting
- Medicare operations
- Compliance program effectiveness audit
- Program audit support and remediation
- Mock program audits
- Delegation oversight
- MAPD and DSNP market entry and operations
- Stars program improvement
- Interim staffing
- CMS, MAPD, and DSNP training
- Model of care
- New plan application support
- Customer Service
- Staff training
- Customer service
- Readiness review preparation
- Interim staffing
- Compliance review
- Market entry or market expansion
- RFP response support
Medicare and Medicaid Provider Consulting
- Provider support
- Revenue cycle management operations
- Value-based contracting
Resources and Brochures
Maximize Your Medicare and Medicaid Business Lines
Our seasoned consultants have worked in senior roles within the health plan and provider sectors and understand the obstacles and barriers you face. Our consulting services team has the breadth and depth of expertise to help both payers and medical providers new to this unique market, as well as those with substantial experience, achieve success.
Need support for
- Expert Healthcare Business, Management, and IT Consultants Learn about each of our expert consultants and how they can help with process redesign, system modernization, clinical transformation, and compliance support. Learn more
- Value-Based Care Consulting See how we help payers collaborate with providers to coordinate care, implement value-based reimbursement models, and drive improved outcomes at a lower cost. Learn more
- Population Health Consulting™ A comprehensive, multi-faceted consulting service for payers and providers who want to both reduce costs and drive better health outcomes across their member populations. Learn more
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