When my Medicaid renewal came up, I was worried about losing coverage. But the process was smooth, and the staff seemed confident and helpful. It made all the difference.

Across the country, Medicaid agencies are under pressure. States must balance the resumption of eligibility redeterminations, new CMS modernization mandates, and the urgent need to maintain continuous coverage for millions. Behind the scenes, eligibility systems—the software, policies, and people who determine whether residents qualify for coverage and services—are doing extraordinary work under extraordinary strain.
Modernization Means More Than Technology

When states hear “Eligibility and Enrollment modernization,” the first thought is often technology: modular Medicaid Enterprise Systems (MES), new APIs, and improved data exchange. Those upgrades are essential. But true modernization is not only about what system is in place—it’s about how people use it consistently and confidently.

Too often, modernization efforts stall because training and change management are treated as afterthoughts. Each vendor provides its own materials; each module speaks a different language, and state teams are left trying to reconcile various styles of documentation while facing daily coverage deadlines. The result? Confusion, duplication, and uneven performance across staff and agencies.

Lower performance directly affects members and providers, resulting in gaps in Medicaid coverage, delays in care or provider payment, increased call volumes and escalations, and slower processing times. This creates a cycle of underperformance that undermines trust and access.

A Unified Approach to Eligibility & Enrollment

Briljent’s experience supporting multi-vendor Medicaid implementations across several states reveals a clear pattern: modernization succeeds when training is unified, modular, and guided by subject-matter experts (SMEs). That’s the foundation of our Training Integrator model—a role that coordinates across vendors, state teams, and system components to deliver one coherent learning experience.

Our approach aligns with CMS requirements, including the Conditions for Enhanced Funding (CEF) described in 42 C.F.R. § 433.112, which apply to all Medicaid Enterprise System (MES) modules. These requirements emphasize not only the development of robust systems, but also the need for comprehensive documentation, transition plans, and knowledge base (training) materials so that systems can be operated by a variety of contractors or users. Briljent’s training solutions are designed to meet these federal standards, ensuring that staff training evolves in tandem with technology and that agencies are prepared for ongoing change. Instead of duplicating vendor materials or relying on outdated handbooks, Briljent curates and standardizes learning content that reflects the real workflows and policies staff use every day.

What That Looks Like in Practice

In a major state eligibility system modernization, Briljent served as the Training Integrator, working alongside the project management office and multiple system vendors. By unifying documentation, developing role-based e-learning, and aligning training with project milestones, Briljent ensured that nearly all users were prepared before go-live. This unified approach resulted in a noticeable reduction in eligibility errors and enabled staff to adapt confidently to new processes.

Briljent recognizes the value of addressing more than just technical integration; we see our role as strengthening collaboration and building institutional knowledge that persists beyond any single project.

As agencies face shifting regulatory landscapes and increasing demands, consistent training and cross-functional coordination ensure staff are prepared for both routine eligibility determinations and unexpected challenges. Ultimately, when modernization efforts prioritize learning, adaptability, and shared understanding, agencies are empowered to deliver on their mission: making health coverage accessible, reliable, and responsive for every community.

This clearly demonstrates that consistent training leads to enhanced operational performance. In a Southeastern state, our team helped build cross-agency alignment between Medicaid, childcare, and nutrition programs during a major eligibility modernization project.

 Why It Matters Now

Eligibility and enrollment modernization is entering a critical window. States must comply with evolving CMS guidance and rebuild public confidence in the Medicaid process. Without coordinated training and governance, even the most advanced systems can produce inconsistent determinations or coverage gaps. Fragmented knowledge management leads to uneven service delivery, and in Medicaid, inconsistency translates directly to gaps in coverage, delays in care, or disruption in provider compensation. Eligibility is far bigger than the technology that support processes.

The Human Side of Compliance

Every policy analyst, eligibility worker, and vendor project manager knows the tension between compliance and compassion. The letter of the regulation must be followed—but the spirit of the program is to help people. When states modernize eligibility systems with a human-centered, SME-informed approach, they create conditions where both goals can thrive. Staff can trust that their training reflects current law and workflow, leadership can trust that compliance risk is reduced, and program members experience more consistent, timely access to care.

Briljent’s Role

When a state Medicaid agency decides to modernize its eligibility systems, it’s not just about updating software or buying new technology. It’s about making sure the people who use these systems—staff, managers, and partners—are ready and confident. That means providing clear training, keeping everyone informed about changes, and making sure new policies and procedures are easy to follow.

Modernization doesn’t stop once the new system goes live. Rules change, staff members come and go, and technology keeps evolving. That’s why it’s important to have a plan for ongoing support: updating training materials, checking in on how things are working, and helping staff stay up to date.

Key Takeaways

Modernization is about people, processes, and technology, and not just IT upgrades.
Unified, SME-led training drives measurable improvements in accuracy and efficiency.
Human-centered modernization builds trust and compliance.

Looking Ahead

In the next few years, E&E modernization will define the trajectory of state health and human services. The states that succeed won’t just have better systems—they’ll have better-trained, better-prepared people behind them. Briljent’s role is to make that possible: connecting technology and training so states can deliver equitable, compliant, and efficient access to care for every resident.

Want to learn more? Contact Briljent for a consultation.