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CITIZ3N Boosts Medicaid Compliance with New Engage Feature

CITIZ3N Government Solutions, a crucial player in health benefits technology for government entities, has recently unveiled an exciting addition to its CITIZ3N Verify Engage platform. This new feature, termed Community Engagement-as-a-Service, promises to facilitate rapid integration with State Integrated Eligibility Systems (IES) and Medicaid Enterprise Systems (MES) while allowing states to retain existing protocols, thus avoiding the drastic measures of replacing legacy systems.

Understanding the Need for a Faster Approach

The health landscape is evolving, with states facing urgent deadlines set by federal mandates for Medicaid expansion populations. These regulations necessitate strict community engagement measures, which historically increased the complexities of operational workflows without necessarily improving member experiences. Recognizing this gap, CITIZ3N aims to streamline processes while safeguarding eligible coverage.

Rob Miller, the General Manager of CITIZ3N Government Solutions, emphasized the company’s commitment to protecting eligible coverage while navigating the intricate compliance landscape. He stated, “Our approach is grounded in trusted data and automation, minimizing unnecessary member engagement.” This dual focus on efficiency and user-friendliness appears to be at the heart of the new service.

Overview of Community Engagement-as-a-Service

With two primary deployment modes, CITIZ3N Verify Engage offers flexibility based on state requirements:

1. Complete end-to-end solution – This integrates both member and staff components, featuring:
- A user-friendly member self-service portal for activity reporting and document submission.
- Comprehensive caseworker consoles for exception management and evidence review.
- Built-in outreach capabilities alongside monitoring and reporting functionalities.

2. Community Engagement as a Service (API-first) – This model caters to states and integrators who wish to uphold their existing systems while enhancing functionalities. Key elements include:
- Secure, easily integrable APIs for seamless compatibility with current systems.
- Automation of determinations and evidence packaging returned to state workflows.
- Optional lightweight member and staff portals to bridge any potential gaps.

Minimizing Administrative Burdens

CITIZ3N Verify Engage operates on the principle of minimizing member burdens while ensuring that program integrity remains intact. By utilizing an initial data-first verification approach, the platform looks to confirm compliance using available information before necessitating member outreach. This proactive stance reduces administrative overhead for state personnel and mitigates the risk of coverage loss due to procedural inefficiencies.

Robust Features of CITIZ3N Verify Engage

The platform boasts several key features that enhance its functionality:

• - Automated verification and inference - Leveraging available state data and third-party sources, the platform adheres to configurable policy rules.
• - Management of exemptions and exceptions - A workflow enhances the ease with which staff can handle specific cases.
• - Monthly compliance operations - Continuous oversight and periodic evaluations ensure adherence before any adverse actions occur.
• - Multi-channel outreach support - This supports transparent communications with members, enhancing stakeholder trust.
• - Reporting and audit readiness - Comprehensive dashboards and traceable data facilitate transparency and accountability in operations.

Ensuring Security and Compliance

CITIZ3N Verify Engage is hosted on a secure cloud infrastructure, ensuring that it meets the stringent security expectations of the public sector. The platform employs encryption methods and access controls, aligning with federal and state security standards to ensure data safety and compliance requirements are comprehensively addressed.

Eugene Sayan, founder and CEO of Softheon, underscored the advantages of the Community Engagement-as-a-Service offering, stating, “States should not have to choose between speed and safety.” By integrating seamlessly with existing systems, this new service empowers states to achieve operational readiness while maintaining necessary compliance measures.

As of now, this enhanced option is available for states and partners looking to implement rapid deployment solutions. For more detailed information, you can visit CITIZ3N's website.