CITIZ3N Gives States a Faster Path to Medicaid Community Engagement Compliance Without Replacing Legacy Systems

New Community Engagement-as-a-Service option integrates with existing state eligibility systems through secure APIs

STONY BROOK, N.Y., Jan. 13, 2026 /PRNewswire/ — CITIZ3N Government Solutions, a technology provider for government agencies overseeing health benefits, announced expansion of CITIZ3N Verify™ Engage with a new Community Engagement-as-a-Service option, enabling rapid integration with State Integrated Eligibility Systems (IES) and Medicaid Enterprise Systems (MES) through secure APIs and batch interfaces.

With states facing tight federal timelines to implement community engagement requirements for Medicaid expansion populations, the new option allows states to add verification capabilities without replacing or re-engineering existing eligibility systems. CITIZ3N Verify Engage helps states manage the full community engagement workflow — verification, exemptions, outreach, cure periods, and monthly compliance evaluation — using a data-first approach that checks available sources before requesting documentation from members.

“We’ve spent more than a decade building solutions that protect eligible coverage while meeting complex verification requirements,” said Rob Miller, General Manager, CITIZ3N Government Solutions. “Community engagement requirements increase operational complexity, but they do not need to increase member friction. Our approach is to start with trusted data, automate wherever possible, and only engage the member when necessary.”

A flexible deployment model built for state realities
The new Community Engagement-as-a-Service option provides an API-first deployment path for states and system integrators that prefer to retain their existing member portals, worker tools, or contact center experiences while offloading the most complex components of community engagement administration.

Through this approach, CITIZ3N Verify Engage can be deployed in two primary modes:

1. Complete end-to-end solution (member + staff experience):

• Member self-service portal for activity reporting, document submission, and status transparency.
• Staff/caseworker console to manage exemptions/exceptions, queues, evidence review, and determinations.
• Built-in outreach and communications workflows and reporting.

2. Community Engagement as a Service (API-first):

• Secure APIs and batch interfaces to integrate with existing IES/MES systems.
• Determinations, evidence packaging, and audit-ready artifacts returned to state workflows.
• Event-driven outputs to support outreach, notices, and cure windows within state-preferred channels.
• Optional lightweight member and staff experiences when needed to close gaps.

Designed to minimize member burden while protecting program integrity
CITIZ3N Verify Engage is built on CITIZ3N Verify, which supports eligibility-related verification and recurring evaluations for millions of lives. The platform applies a data-first verification sequence to confirm compliance and exemptions using available sources before escalating to member outreach or documentation. This reduces administrative burden for state staff and lowers the risk of procedural coverage loss due to avoidable paperwork steps.

Key capabilities include:

• Automated verification and inference – Data-first evaluation using available state and third-party sources with configurable policy rules.
• Exemptions and exceptions management – Configurable exemption and hardship exception handling with workflow queues for staff review.
• Monthly compliance operations – Continuous monitoring, recurring evaluation, and configurable cure periods prior to adverse action.
• Outreach and communications support – Auditable, multi-channel outreach orchestration aligned to state operations.
• Reporting, oversight, and audit readiness – Dashboards, extractable data, and full evidence traceability to support audits and appeals.

Security, privacy, and compliance posture
CITIZ3N Verify Engage is delivered as a secure, cloud-hosted platform designed to meet public sector security expectations. The platform supports single-tenant client environments with encryption in transit and at rest, access controls, monitoring, and audit logging. CITIZ3N aligns its controls to all applicable federal and state security requirements.

CITIZ3N is a subsidiary of Softheon, a leading cloud-based shopping, eligibility, enrollment, billing, and member management solution for health plans, their enrollment partners, and government agencies. For CITIZ3N and Softheon, Verify Engage reflects a core approach to public sector technology.

“States should not have to choose between speed and safety,” said Eugene Sayan, founder and CEO of Softheon. “Community Engagement-as-a-Service gives states a rapid path to operational readiness by plugging into existing eligibility systems, while still delivering the data-first verification, configurable policy rules, and auditable evidence trail necessary to protect eligible coverage and meet oversight expectations.”

The Community Engagement-as-a-Service option is available immediately as part of CITIZ3N Verify Engage for states and partners evaluating rapid deployment paths. To learn more, visit CITIZ3N.com/verify.

About CITIZ3N
CITIZ3N Government Solutions is a premier provider of integrated, modular platforms specifically tailored for government agencies overseeing Affordable Care Act (ACA) Marketplaces, Medicaid, Health & Human Services (HHS) and Government Health Benefits for Employees. The collaboration between CITIZ3N and Softheon epitomizes a shared vision of promoting innovative solutions that enhance affordability, accessibility, and efficiency, thereby fostering healthier citizens. For more information on CITIZ3N’s solutions, visit www.CITIZ3N.com.

About Softheon
Founded in 2000, Softheon’s healthcare Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans, their distribution networks, and government health agencies. Currently, Softheon’s solutions serve over 100 health plans. Issuers and consumers in Small Group, ICHRA, Dental, Medicare, and Affordable Care Act (ACA) markets benefit from Softheon’s technology that reduces administrative overhead and enhances user experiences. Softheon is an Agent and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. Softheon is recognized as one of the World’s Top HealthTech Companies of 2025 by TIME. For more information on Softheon’s solutions, visit www.softheon.com.

Media Contact
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SOURCE Softheon