Case Study: Large National Payer Company wins state Medicaid contract and builds comprehensive statewide provider network with Optum

Large National Payer Company - Customer Case Study

Large National Payer Company, with a strong presence in the Southwest, faced a six-month deadline to respond to a state RFP and build a Medicaid provider network—work that would compete for more than a billion dollars of future business. The payer engaged Optum for provider network development and consulting services to lead the RFP response and establish relationships in regions where it previously had no footprint, including a Native American reservation.

Optum’s consultants acted as health plan representatives, securing letters of intent from providers, ancillary partners, and facilities (including on Native American lands), introducing the payer’s medical delivery standards, and navigating state and internal approvals. As a result, Optum helped the Large National Payer Company win the state contract, become the Medicaid service provider for the identified service areas, and lay the groundwork for a comprehensive behavioral and physical health system—delivering measurable wins (letters of intent, contract award) within the tight timeline.