The client is the largest Medicaid managed care organization in the U.S​
Business Challenge
The client’s strategic objective was to decrease administrative burdens, enhance performance in the context of risk adjustment, and attain precise understanding of members. This included furnishing comprehensive insights into the conditions of these members, thereby enhancing the overall information available to provider-partners.
- Streamlined operations for a Medicaid managed care organization through automation, reliable infrastructure, and integrated supplementary functionalities
- Over the course of 5 months, Infinite facilitated the bi-directional exchange of information through automation to enhance the visualization of member statuses.
- The solution was hosted within the OptaFi Azure Tenant, ensuring a robust and reliable infrastructure.
- Other supplementary functionalities, including HEDIS/Quality, Prior Authorization, and Utilization Management, were successfully integrated.
- The proposed solution involved implementing essential features as:
1) Clinical Data Exchange 2) Image Exchange 3) Additional Detail Requests 4) Risk Adjustment
- 20%Â IT Services Cost Optimization
- 30% Additional Cost Savings using OptaFi Cloud Security Framework
- 35%Â Â CSATÂ Improvement
Related Case Studies
Case Study
Strategic transition approach reduced IT costs, improved adherence, and delivered savings.
Case Study
Streamlined domains and enhanced workflow orchestration, and heightening efficiency.
Case Study
Cost savings, increased reliability, and enhanced efficiency via end-to-end testing.
Case Study
Improve auto adjudication and reduced claims backlogs for a Fortune 500 payer.
Case Study
Azure Cloud transition provided easy access and a scalable IT ecosystem.
Case Study
Comprehensive IT transformation afforded significant cost savings.
Case Study
Streamlined and optimized client workflows and processes.