Finance Module for MAXIMUS Children's Health Insurance Management Platform

  • Implementation of interfaces to external financial services
  • On-site visits, flawless communication across project teams
  • 10% under planned budget, 100% meeting Customer’s expectations

Customer

Maximus Inc. is a leading provider of business process services assisting governments in the United States, Australia, Canada, the United Kingdom and Saudi Arabia in administration of public programs. In recent years the 9,000-employee US-based company has primary focused on government-sponsored health and human services, supporting such gravitation with an active acquisition strategy.

Challenge

Through acquisition of one of their direct competitors on the USA’s CHIP (Children's Health Insurance Program) market Maximus Inc. received a proprietary platform automating health insurance processing and eligibility determination. The platform helped handling changes in government regulations related to health insurance, which made it strongly appealing to the US state governments.

But given the independent implementation of the CHIP program by the US states, the platform was only suited to be used in Colorado – the state serviced by the acquired company. To make the platform accessible nation-wide, Maximus Inc. needed to customize it to fit for the CHIP implementation model and administration specifics of each particular state.

Vendor Selection

Maximus Inc. embarked on a search for a reliable technology partner to handle the development effort. Itransition had previously been involved in a project for another department of Maximus. The first-rate results delivered made us the primary candidate to consider for the current project. Besides, the decisive factors to choose Itransition turned out to be:

  • skilled Java stack developers meeting strict evaluation criteria: the candidates proposed by Itransition were approved by Maximus Inc. in the course of rigorous staff interviewing process
  • proven track record of delivered solutions handling financial and insurance-specific workflows
  • ability to frequently visit the Customer’s office based in Denver

Solution

Finance Module Implementation

Within the scope of system customization for the Florida state, Itransition was responsible for implementation of the Finance module. The developed module represents a set of interfaces for integration with external financial institutions to enable tracking financial transactions.

The solution processes heavy volumes of personal financial data related to health insurance, its functionality including:

  • creating refunds
  • reversing completed refunds
  • moving money between accounts
  • withdrawing money from accounts
  • recording returned payments
  • viewing financial summary and transaction history
  • pre-approval and rejection of refunds
  • inactivation of ACH payment arrangements, etc.

Results

The Itransition team has successfully implemented the platform’s finance module for the state of Florida, living up in full measure to the Customer’s expectations in terms of team performance. Flawless communication at integration points was established with 8 other teams involved in the project. The project budget totaled 10% lower than that estimated by the Customer at the project initiation stage, with Time & Materials pricing model applied.

The solution is currently used by tens of thousands of public organizations’ employees when servicing millions of children eligible to health insurance under the CHIP program.

Maximus Inc. is currently planning to customize the platform in a similar manner for the state of Georgia.

Highlights

  • Solutions

    Billing & Payments

  • Industries

    ISVs

    Banking & Finance

  • Technology

    Java

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