Modernizing Provider Data Management at CMS
CMS needed a unified platform to modernize how provider information is collected, validated, and shared across the healthcare ecosystem. Historically, providers and practice delegates were required to log into multiple fragmented systems to update their demographic and credentialing information—resulting in redundancies, data inconsistencies, and a high administrative burden.
The challenge was to design a centralized, scalable solution—the Qualified Health Plan (QHP) Directory—that would streamline workflows, improve data accuracy, and reduce friction for providers participating in the Health Insurance Marketplace.
Client: Centers for Medicare & Medicaid Services (CMS)
Role: Lead UX Designer
My Role & Contributions
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Partnered with policy, engineering, and stakeholder teams to shape platform UX
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Led experience design for provider and delegate workflows, ensuring intuitive interactions
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Mapped current-state pain points across legacy systems and touchpoints
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Created user flows, wireframes, and interactive prototypes
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Supported testing, accessibility reviews, and iterative improvements across sprints
The Process
Research & Requirements Gathering
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Reviewed federal credentialing regulations and Marketplace workflows
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Interviewed internal CMS teams and provider representatives to understand current-state challenges
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Identified inefficiencies and pain points in multi-system login and data entry processes
UX Design & Prototyping
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Developed wireframes and journey flows to consolidate key user tasks into a single interface
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Designed for clarity, validation, and flexibility—accommodating multiple user types and data sources
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Collaborated with developers to ensure technical feasibility and regulatory compliance
Testing & Refinement
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Conducted stakeholder reviews and iterative usability testing
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Validated improved data flows and UI clarity for both providers and delegates
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Integrated feedback into refined components and structured onboarding processes
The Impact
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Successfully launched a centralized, secure platform that reduces the need for multiple logins and duplicative data entry
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Enhanced provider engagement and data governance, increasing trust in CMS systems
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Improved the accuracy, consistency, and timeliness of provider data shared on the Health Insurance Marketplace
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Supported regulatory compliance and laid groundwork for nationwide adoption of a modernized provider directory infrastructure
