“What made our Anoteros partnership successful was their ability to manage complex enterprise transformation and accelerated implementation timelines through subject matter expertise combined with domain analyst engagement and excellent project management.”
— Stuart Myer, Chief Information Officer, VillageCareMAX

VillageCareMAX, a New York health plan serving governmental programs, including Medicaid Managed Long-Term Care (MLTC) and Medicare, faced significant operational and technological constraints that were limiting its ability to efficiently serve its members and compete effectively in the market. The organization’s existing administrative and IT infrastructure was creating bottlenecks across critical business functions, resulting in low auto-adjudication rates, extensive manual workarounds, and limited automation capabilities.

The health plan’s core operational areas—spanning enrollment and eligibility, premium billing, claims processing, encounter management, provider network management, and regulatory reporting—were operating with disparate systems and processes that hindered efficiency and scalability. Manual interventions were required for routine tasks, creating operational burden and increasing the risk of errors. Additionally, third-party integrations were insufficient to support seamless data exchange and workflow automation.

Recognizing the need for transformation, VillageCareMAX made the strategic decision to transition to a Business Process as a Service (BPaaS) vendor model to modernize its operations. However, they faced the complex challenge of implementing the new vendor in a very compressed timeline while ensuring the chosen solution could address comprehensive operational needs across all functional areas to ensure a successful transformation.

Anoteros served as VillageCareMAX’s strategic implementation partner, acting as the bridge between the plan and the selected BPaaS vendor to ensure a seamless transition. Our approach centered on five core pillars: strategic partnership facilitation, accelerated implementation management, enterprise system integration, operational excellence, and change management.

Strategic Partnership Facilitation Anoteros positioned itself as an advocate for the health plan and a liaison with the BPaaS vendor, ensuring that the health plan’s operational requirements and regulatory constraints were fully understood and addressed. We partnered with the BPaaS vendor to create clear communication protocols and governance structures that facilitated transparent collaboration between all parties while maintaining the plan’s strategic interests throughout the engagement.

Accelerated Implementation Framework Recognizing the accelerated timeline, Anoteros developed an integrated project plan that encompassed internal and external tasks to align with the go-live dates. Working closely with VillageCareMAX, its other external vendors, and the BPaaS vendor, multiple workstreams were formed that allowed for simultaneous configuration, testing, and training activities. Our team coordinated with all stakeholders by holding daily standups, weekly milestone reviews, and executive-level steering committee meetings to maintain momentum and quickly address any emerging issues.

Comprehensive Enterprise Systems Integration Management Anoteros led the complex technical integration planning required to connect legacy systems, external state systems, and other third-party systems with the new BPaaS partner. We led data mapping exercises, developed integration specifications, and coordinated testing protocols to ensure seamless data flow across enrollment, claims, billing, service delivery, and reporting functions. Our technical team worked closely with both internal IT staff and the BPaaS vendor’s implementation team to resolve integration challenges proactively.

Operational Excellence Our dedicated team of Subject Matter Experts documented business requirements and developed new processes to improve operational outcomes. We assisted with the development of a robust testing strategy, post-go-live quality assurance programs, and risk mitigation strategies to protect the health plan’s operations during the transition and beyond. We worked closely with all parties to develop contingency plans for critical business functions, implemented parallel testing environments, and developed cut-over plans to ensure business continuity. Our team assisted with comprehensive user acceptance testing and regulatory compliance reviews to validate that all systems met operational and regulatory requirements before go-live.

Change Management and Stakeholder Alignment Understanding that successful transformation extends beyond technology, Anoteros developed a comprehensive change management strategy that addressed both organizational and individual adoption challenges as well as internal and external communications. We facilitated stakeholder workshops, developed customized provider communications and training programs, and created communication plans that kept all team members informed and engaged throughout the transition.

VillageCareMAX successfully implemented the new BPaaS vendor within the project timelines while positioning the organization for sustainable growth in the competitive New York health plan market. VillageCareMAX eliminated the bottlenecks that had previously hindered efficient operations, replacing manual workarounds with automated processes to reduce processing times and improve accuracy.

The comprehensive enterprise systems integration successfully connected legacy systems, external state systems, and third-party platforms with the new BPaaS solution. This integration created seamless data flow across enrollment, claims, billing, service delivery, and reporting functions, eliminating the data silos. The unified system architecture now supports real-time dashboards, information sharing, and automated workflow processes across operational areas.

The successful implementation was completed within the compressed timeline while maintaining business continuity and protecting member services throughout the transition. This achievement demonstrated the effectiveness of Anoteros’ strategic partnership approach and VillageCareMAX’s commitment to operational excellence in serving vulnerable populations through Medicaid MLTC and Medicare programs.

Bottom Line: This engagement showcased Anoteros’ ability to serve as a trusted strategic partner, successfully navigating the complexities of healthcare IT transformation while ensuring business continuity and positioning VillageCareMAX for sustainable growth.

Ready to transform your organization’s operational capabilities? Contact Anoteros to discuss how our strategic partnership approach can drive your next critical transformation initiative.