Our Care Management application is clinically-driven and powers workflows for utilization management, case management, condition management, prevention, and wellness, all through a centralized member dashboard. It aligns provider authorizations, incentives, assessments, and care plans with insights produced in our Healthcare Benefits Analytics application, or the third-party benefits analytics platform of your choosing. This ensures users focus on the activities that will yield the greatest health and financial impact.

• UTILIZATION MANAGEMENT:

Organize and oversee utilization and monitor procedures and referrals that require prior authorization, all from a single consolidated dashboard.

• CARE MANAGEMENT:

Prioritize members based on clinical or financial risk factors and monitor outreach and interventions. Centralized dashboards draws focus to the touchpoints and activities that can reduce risk and improve outcomes.

• HEALTH ENGAGEMENT:

Extend a brandable member-facing health portal for care managers to administer individualized care plans, health risk assessments, and communicate information on health plan incentives and rewards. Members can send secure messages, communicate health-related data, and complete assessments.

• INCENTIVE MANAGEMENT

Monitor the status and effectiveness of incentive programs and communicate progress with members through a health portal.

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