Medicare and Medicaid stamps

Providing Medicare and Medicaid data support

JOS Group, LLC provides healthcare subject matter expertise around Claims Processing for Part A, B, Medicare Advantage, Part D and Medicaid. We provide services and support to over 25 business centers, translating policies and healthcare questions to data navigation, analysis and data support services. This has helped detect over $4B in Medicare and Medicaid fraud while improving quality of care.

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Driving solutions to address mental health crisis

We have built machine learning algorithms to help solve mental health crisis, such as the “path to opioid overdose”. We also have created prototype products around veteran suicide attempt analytics to help with early detection and intervention.

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Addressing health equity

We have provided health equity and analytical impacts at CMS during COVID-19 and beyond on preexisting conditions and vaccines administration, including social determinant factors in conjunction with geospatial intelligence.

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Breaking down silos to build Enterprise Strategic Solutions

We have been leading the management and implementation of large-scale data repositories, building a Center of Excellence for Centers of Medicare and Medicaid Services (CMS) and Indian Health Services (IHS) to standardize, harmonize, integrate, enrich and secure the data reducing silos. Driving a data center of excellence for CMS centers on leveraging Snowflake “Data Cloud” and other technologies as enablers. We have also have standardized the solution to FHIR interoperability standards to support electronic health records.

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Supporting program evaluation and grants management

Our team is experienced at reviewing grant applications to ensure compliance with reporting requirements. We analyze grant data to assess program effectiveness while identifying strengths, weaknesses, and areas for improvement. We report to stakeholders regularly on grant program status.

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Medicare advantage expertise

We are experts on Medicare Advantage policies, program operations, risk adjustment, health plans performance and submissions for Centers of Medicare and Medicaid Services.

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Workforce elevation through training and data coaching services

Leading multiple training and coaching services, we provide training around data and AI, program policies and like subject areas to increase awareness, competencies and provide engagement to help agency task leads to make better decisions on their jobs for various projects and new innovative solutions.

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Data Modernization and Cloud hosting

We are very capable at leading data modernization projects. Machine learning and AI implementation, sunset legacy systems, created feasibility study analysis around new systems, end to end migration to the cloud, and hosting the infrastructure on Microsoft Azure Cloud platform providing Snowflake/SAS/Open-Source Integration.