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The largest segment of our business is focused on health plans and insurance companies and assisting you with compliance, operations and interim staffing solutions. Our seasoned Medicare/Medicaid/Commercial subject matter experts and business managers have worked in the trenches at plans and understand the challenges facing you with resource limitations, systems issues, vendor oversight and the onslaught of daily CMS guidance and state/federal regulations.  Here are some of the services we offer:


BluePeak staff has worked on both sides of the CMS world, as plan business owners and CMS auditors and regulators. This gives BluePeak the edge of being able to support plans, understanding the business challenges that you face, as well as how CMS will audit you and their processes.  This allows for better preparation and maintenance of your compliance programs.


BluePeak staff has worked in the trenches at health plans and understand the challenges that businesses face with limited resources and increasing CMS and state/federal demands. Our team can provide subject matter expertise across all operational areas of your business to enhance your business processes, fill in compliance gaps, provide interim staffing and train your staff to enhance their efficiency and effectiveness.


BluePeak has seasoned experts who are proficient at product strategy and development.  Whether it is assisting plans to go into new markets with new products, providing direction on starting an EGWP or PDP, or providing CMS benefit design and bid assistance, BluePeak can support new and existing plans to help grow their businesses.

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Experienced Medicare staff: Ready when you are!

BluePeak knows how difficult it can be for Medicare Advantage plans and TPAs to find knowledgeable resources with experience in Medicare, especially when demands increase sharply given the Medicare annual cycle. BluePeak maintains a wide variety of experienced Medicare personnel to help you with seasonal projects, operational backlogs, compliance monitoring, remediation activities, and more.

Examples of projects that BluePeak has assisted plans in 2022 include:

  • Clinical chart review by licensed clinicians
  • Call center oversight, including listening to calls for accurate classification and calibration
  • Operational support to resolve grievance backlogs and provider directory compliance
  • Pharmacy support to resolve coverage determination backlogs
  • Program area specific operational and administrative responses to a corrective action (initiated internally or externally)
  • Compliance resources to support compliance program initiatives

Whether you need one resource or many, BluePeak can quickly staff any project, train resources, track results, and deliver success.

Contact us today!