Medicaid Program Management

Upgrade Medicaid one step at a time to fight fraud and cut costs

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Delivering for our clients at scale

16M
recipients supported annually
$1B
pharmacy claim payments managed annually
18
successful MMIS systems certifications

Improve integrity and efficiency without overhauling your system

Many state Medicaid programs still rely on legacy systems that are costly and difficult to upgrade. These platforms limit service efficiency, data visibility and compliance.

Conduent Medicaid Suite (CMdS) makes it easier to move forward. By supporting incremental upgrades and step-by-step flexibility, CMdS helps agencies modernize on their terms while improving access, performance and alignment with MITA and CMS goals.

Integrated analytics and reporting, including enterprise data warehousing, give agencies the power to streamline operations, strengthen oversight and deliver better results for the people they serve.

*Source: Medicaid.Gov

  • Optimize budgets

    Ensure data-driven decisions and performance with advanced web-based analytics that provide key insights into finances, trends and usage.

  • Modernize incrementally

    Upgrade systems step by step to minimize disruption, control costs, and adapt to evolving program needs.

  • Boost program integrity

    Leverage pre- and post-payment tools to verify accurate coding, streamline claims processing and manage financial transactions with precision.

Conduent Medicaid Suite (CMdS)

Modern, scalable Medicaid Enterprise Systems

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  • Fight fraud, waste and abuse

    Advanced identity checks and real-time analytics prevent fraud before it starts

  • Improve system performance

    Modular tools support incremental upgrades without disrupting services

  • Harness the power of data

    Web-based dashboards provide real-time insights into operations and spending

  • Identify inaccurate claims

    Pre- and post-payment checks ensure claims are valid and compliant

  • Mitigate staffing shortages

    Skilled professionals provide operational and technical support

  • Reduce and eliminate barriers to access

    Streamlined eligibility and enrollment tools reduce friction

Medicaid Program Management: Commonly asked questions

How can Medicaid agencies improve operational efficiency?
Modernizing legacy systems with scalable, cloud-based solutions like Conduent Medicaid Suite (CMdS) can streamline operations, reduce costs, and enhance service delivery. These solutions also ensure compliance with CMS standards and adapt to evolving regulatory requirements.

What strategies help Medicaid agencies address rising enrollment numbers?
Leveraging advanced data analytics and automated workflows enables agencies to handle increased demand efficiently. Tools for eligibility verification, claims processing, and fraud detection also help manage growing caseloads without compromising accuracy or timeliness.

How can Medicaid agencies stay ahead of regulatory changes?
Agencies can adopt flexible, modular technology solutions that quickly adapt to new CMS requirements and state-specific regulations. Partnering with experienced vendors like Conduent ensures compliance, minimizes disruption, and keeps systems aligned with evolving healthcare policies.