U.S. Health Plan Rapidly Expands in Affordable Care Act and Medicaid Using Facets

Summary:

A U.S. health plan aimed to rapidly expand its product lines into the Affordable Care Act and Medicaid sectors across multiple states. Facing the challenge of converting their legacy system to TriZetto’s Facets platform without the necessary expertise or processes, they enlisted SourcEdge’s help to navigate the expansion.

Results:

  • Successfully configured the Facets platform to support new Medicaid and ACA product lines, enabling the health plan to enter new markets swiftly.
  • Developed and executed a comprehensive project plan, covering requirements gathering, design, build, testing, and deployment, ensuring a structured and efficient process.
  • Mentored and trained the client’s team across various departments, establishing a solid foundation for ongoing operations and future expansions.
  • Created and implemented detailed documentation and project tracking processes, significantly enhancing project visibility and management for executive leadership.
  • Positioned the client as a fully qualified insurance provider, transitioning from a third-party administrator to a recognized player in the insurance market.