Home
LinkedIn Facebook Twitter
  • SUBMIT RFP
  • CONTACT US
  • HOME
  • Email Signup Menu
Skip Navigation Links
  • About Us
    • Clients
    • Community Involvement
    • Contact Us
    • Core Values
    • Leadership Team
    • Project Summaries
    • Testimonials
  • Industries
    • Healthcare
      • ACOs and Clinically Integrated Networks
      • Health Plans and Payers
        • Business Process Optimization
        • Co-ops and Small Plans
        • Information Technology
        • Operational Assessment
      • Providers
        • Electronic Health Records
        • Health Information Exchange
        • Population Health Management
      • Regulatory
        • Interoperability
        • Meaningful Use and Advancing Care Information Program
        • Quality Payment Program – MIPS and APM
    • Higher Education
    • Life Sciences
    • Manufacturing
      • Enterprise Resource Planning (ERP)
        • Assessment of Existing ERP Solution
        • ERP Vision, Strategy, and Roadmap
        • ERP System Selection and Integration
      • Process Improvement
      • Supply Chain Management
    • Public Sector
    • Telecommunications
      • Call Center Solutions
      • Enterprise Subscriber Management and Billing
      • Telehealth
  • Service Lines
    • Business Intelligence and Analytics
    • Customer Relationship Management
    • IT Effectiveness
      • IT Strategy
      • IT Process Improvement
      • IT Governance
      • IT Procurement and Vendor Management
    • Project, Program, and Portfolio Management
      • Definition and Planning
        • Business Case Development
        • Planning and Estimation
        • Kickoff and Initiation
      • Project Execution
        • Management and Control
        • Risk Management
        • Change Management
        • Quality Management
        • Benefits Realization
      • Program Management Office (PMO)
      • Project and Program Assessment and Review
      • Portfolio Management
      • PPM Tool Selection and Integration
    • System Selection and Integration
      • Business Case Development
      • Requirements Definition
      • Vendor Evaluation and Selection
      • Contract Negotiation Support
      • Solution Integration
        • Analysis and Design
        • Solution Development and Configuration
        • Testing, Training and Cutover
      • Evolution Planning
  • Careers
    • Apply Online
    • Benefits
    • Core Values
Skip Navigation Links.
Healthcare
ACOs and Clinically Integrated Networks
Health Plans and Payers
Business Process Optimization
Co-ops and Small Plans
Information Technology
Operational Assessment
Providers
Regulatory
Higher Education
Life Sciences
Manufacturing
Public Sector
Telecommunications

HomeSkip Navigation Links > Industries > Healthcare > Health Plans and Payers > Co-ops and Small Plans

Placeholder imageCo-Ops and Small Plans

In this ever evolving health insurance market, co-ops and small health plans have been significantly impacted with start-ups costs and have faced significant challenges with integrating into the Federally-Facilitated Marketplace and state-based exchanges.  Although often led by payer veterans, the challenges are different than the larger plans, need to be implemented on a short timeline, and often with a small budget.  This can lead to interim solutions that needs to be upgraded to more complex solutions within a couple of years of startup.

JCS consultants have worked with small health plans from the ground up.  We have experience in helping small plans establish a foundation in which to operate for the first couple of years as well as the experience to migrate to a more sophisticated solution within two years.

Some of our experience includes the following:

  • Defining an overall IT blueprint and strategy

  • Serving as an interim CIO/CTO

  • Managing the overall program to bring up the business and the technology solutions, including the foundational infrastructure, budget, and staffing needs

  • Defining requirements, developing Requests for Proposal (RFPs), and managing the selection process for a variety of technology solutions including enrollment, eligibility, customer relationship management (CRM), call center technologies, billing and payments, fulfillment solutions, portals solutions (member, broker, and provider), etc.

  • Serving as project managers and business analysts to implement the technology solutions

  • Defining end-to-end processes across the organization including interaction with departments, individuals, technology solutions (internal and external), and vendor partners

  • Designing and developing an internal solution to manage data integration, cleansing, transformation, and processing to downstream vendor partner (dental, vision, third partner admistrator (TPA), medical management, etc.).  Migrating from the external vendor to the internal solution.

Do you need to validate your current situation and understand your options for improvement?  Let us do an Operational Assessment.

For more information on how we can help you, contact us.

 


JCS Library

JCS Overview

Project, Program, and Portfolio Management (PPPM)

IT Effectiveness

Business Intelligence

 
©2009 - 2016 Jimenez Consulting Solutions, LLC. All Rights Reserved
10450 N. 74th St., Ste. 160, Scottsdale, AZ 85258
(480) 237-9200
Privacy Policy