Case Study

Managed Care Organization

Transformation Management

Situation

  • Supported the largest Orthotic and Prosthetic (O&P) provider organization in the US to plan and execute the go-live of a wholly owned Managed Care Contracting subsidiary
  • Implemented a national contracting and centralized billing aggregator
  • Developed parent company stakeholder and governance (Board) approval reporting

SMA Services

Strategic Review

Business Planning

Technology Alignment

Business Transformation

Actions & Impact

  • Planned and facilitated design and implementation efforts for 8 separate operational readiness workstreams
  • Led requirements development, vendor identification, RFP solicitation/response and selection of claims processing, front-end intake, payment remittance and data/analytics reporting systems
  • Supported staff hiring, on-boarding and training activities for 30+ new staff members
  • Created Standard Operating Procedure (SOP) Planning and documentation framework for 25+ new or enhanced SOPs
  • Facilitated integration project communications across 10 separate 3rd party vendors

Results

Implemented Centralized Contracting Model

Operationalized $50M in Year 1 Billings