The Client Challenge
A large national Medicaid health plan covering more than 5 million lives sought to improve its heavily manual, non-standardized, and lengthy provider onboarding process. It was also in the process of implementing a new provider lifecycle management platform and wanted to take full advantage of the new technology’s capabilities to stand up provider networks quickly and strengthen the provider enrollment experience.
A NEXT-GEN PROVIDER ONBOARDING EXPERIENCE:
- Serves as a strategic differentiator during provider network recruitment
- Reduces provider enrollment processing time
- Lays the foundation for complete and accurate provider data to inform downstream system needs, such as the provider directory
- Allows members to access preferred providers quickly
Navigating to Next: The Solution
Based on a strategic roadmap developed with Chartis for the end-to-end provider lifecycle experience, the health plan sought to increase automation and improve efficiencies in the provider enrollment and onboarding processes. As part of the strategy, a key recommendation was implementing an enterprise-wide, standardized, best-in-class onboarding process in conjunction with a new provider lifecycle management platform. Along with fully leveraging the new technology’s capabilities, the health plan’s leaders wanted to align multiple stakeholders across numerous markets with varying priorities on a standardized enterprise approach. But doing so would be challenging.
The health plan partnered with Chartis to design the end-to-end provider onboarding process. Multiple workgroups were formed to engage key stakeholders across the organization and with the vendor to align on a future-state vision and ensure the technology would be configured to achieve business objectives. Performance indicators and goals were identified to gauge success and allow for continuous improvement. Four of the health plan’s markets were identified to serve as pilots prior to implementation of the larger enterprise rollout.
