MEDICAID ENTERPRISE SYSTEMS (MES) AT SEDNA
The Sedna team has a long history of delivering comprehensive solutions, offering management expertise, and program knowledge to State Health and Human Services Agencies, addressing the IT needs of various social service program areas.
Our
Experience
The Sedna Team has assisted the design, development, and implementation support of modifications to existing Medicaid Enterprise System (MES) modules, which includes claims processing and audit functions.
plus years of experience
Current
Focus
Our team provides the following services:
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Providing support of the existing Medicaid System
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Reviewing requirements documentation to determine accuracy of the intended solution.
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Attending project status meetings and reporting on the status of their team.
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Advising on process improvements within the areas of their subject expertise and provides mentoring to HFS staff in their subject expertise.
The Sedna Team is currently assisting in the requirements definition and design of a new Medicaid and Pharmacy Benefits system.
To execute an ambitious reengineering of a Medicaid delivery system, Sedna brings expertise in the following areas:
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Project management and consulting experience
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Medicaid business analysts and application support expertise with Medicaid business area managerial or leadership experience and capability:
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Waiver Program Management
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Reimbursement
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Federal Reporting
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Program Integrity
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Long Term Care
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Managed Care
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Provider enrollment
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Provider Management
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Member Management
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Claims Processing
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Pharmacy Program
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Collections / Recovery
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Fiscal Management
Why
Sedna?
Get the large vendor experience with the personalized attention of a small business.
Subject Matter Experts (SMEs) with industry knowledge to tailor solutions to each client
More than 18 years of excellent service delivery and relationships with state, local, and federal vendors and partners
Experienced team with functional and technical expertise and industry standard certifications (e.g, PMP, Oracle, MCSA, etc.)
Strong value-led organization prioritizing integrity service, excellence, inclusion, dependability, and community focus for all partners.
Our Impact
Our departments have included construction and enhancement of most of the mission critical human services and healthcare software applications, support for the technical infrastructure platform, and post implementation support. Each technology engagement has provided business solutions for complex statewide applications in the public assistance and public health arena, interpretation of Federal policy and decision support processes, and mission critical integration of data between public assistance programs servicing the same client.
Discover a fascinating case study exploring the tangible benefits of optimization techniques applied to the VA PREMIER Medicare & Medicaid web portal in the State of Virginia. Uncover how these strategic enhancements revolutionized the user experience and maximized efficiency in this captivating study.
Sedna Consulting Group is a minority, woman-owned small business specializing in computer services and solutions across a broad spectrum of technologies. Our flexible and comprehensive service delivery model enables us to efficiently and effectively support public sector organizations and diverse industries and businesses of all sizes.