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TriZetto Healthcare Products / Medicaid

Boost your Medicaid efficiency

Cognizant’s automated and integrated Medicaid Solutions Portfolio helps plans prepare for Medicaid’s rapid growth and constant change.
With more than 82 million individuals expected to be eligible for Medicaid by 2026, today’s Medicaid plans are preparing for rapid growth as they deal with state budgets in crisis. To succeed, plans must maximize administrative efficiency, navigate the demands of healthcare reform and transform operations to meet continuously changing business requirements.
Our solutions support more than 60% of the nation’s managed Medicaid lives in 42 states. Our core administration solutions provide a flexible and scalable foundation for your Medicaid line of business. And when combined with our additional point solutions, they help further streamline processes and enhance the quality of care delivered to plan members.
Covering all bases
This combination of products and services encompasses all aspects of Medicaid administration, from claims processing to medical and network management. Plan benefits include:
    • Improved compliance with CMS requirements.
    • Maximized efficiencies through increased automation.
    • Nearly seamless transactions between providers, members and your plan.
    • Entire encounter submission and response file process management.


Core Administration

Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.

Cognizant Interoperability Solutions

Offers end-to-end solution that pairs modular SaaS products with industry-leading strategic consulting to connect disparate systems, standardize data and enable secure, authenticated access in real-time.

Provider Reimbursement Solutions

Automates pricing scenarios to provide the best value to payers, providers and patients.

Quality Management

Enables payer/provider collaboration to reduce costs and drive overall quality improvement.

TriZetto® EngageMember®

Members may interact anytime, anywhere and receive a detailed view of their coverage information with compelling metrics, timely notifications and relevant healthcare content.

Business Process-as-a-Service

This integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

TriZetto® EngageProvider®

Enables physicians and other care providers to access detailed information on their patients, efficiently log claims and make templates for common claims, as well as easily create referrals and authorizations.

Trading Partner Management

Manages EDI trading partners with one cost-effective, cloud-enabled technology service.

Care Management

Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.

Optimization Software Products

Automate and simplify operational tasks associated with our core healthcare technology solutions, Facets and QNXT.

TriZetto Elements®

Extend the functionality of your core system by providing critical capabilities from enrollment through risk adjustment, to efficiently administer government solutions.

Portal Technology

Automates transaction processing and information exchange between payer organizations and their external constituents.

Related services

Business process services

Services that offer meaningful business outcomes.

Business consulting

Benefit from our unparalleled healthcare business consulting expertise.

Next-gen technologies

Put next-generation technologies in place that build a stronger, more agile business and lay the groundwork for future AI and automation initiatives.

Infrastructure services

Get services that ease the strain of managing your infrastructure so you can focus on managing your business.

IT professional services

Take advantage of our unrivaled resources and healthcare expertise to meet your IT business needs.

Services/Benefits administration

Apply our proven software, technology, expertise and tested methodologies to manage your business more effectively.

Business process-as-a-service

Our integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

Contact us

At Cognizant, we are here to provide you with more information about our TriZetto Healthcare Products software and service solutions and answer any questions you may have.

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