Behavioral Health

Design and deploy a robust array of purpose-built behavioral health management programs and partnerships across the mental health spectrum from stress resiliency through serious mental illness needs

Care Delivery

Transform delivery of innovative, affordable and high quality care models through organizational transformation, new partnerships or new business ventures

High Cost Claim and Member Management

Align holistic and integrated programs to segment and successfully serve high-cost members and high-dollar claims efficiently and effectively

Medical Cost Action Planning

Harness the power of the enterprise to analyze, prioritize, and integrate initiatives that will deliver cost and utilization improvements through cohesive and efficient deployment of provider network management, clinical, pharmacy and behavioral health programs, medical policies and product/benefit structures

Member Advocacy
and Concierge

Transform healthcare member services through more personalized, omni-channel, highly-efficient, and holistically-integrated administrative and clinical services that deliver improved member engagement and outcomes (cost, quality
and experience)

Network and Product Design

Design and deploy competitive, and impactful “Big P” and “little p” healthcare products via high quality network structures and innovative benefit and program offering designs

Pharmacy Management

Design and deploy a robust portfolio of pharmacy solutions that optimize affordability and outcomes within one of the highest growing areas of innovation and costs within healthcare

Population Health Management

Deploy deep population insights across demographics, cost, quality and utilization metrics to segment and successfully serve population cohort needs

Provider Performance Management
and Risk Enablement

Deploy robust provider performance management programs, informed by analytic insights, that strengthen partnerships and enable providers to succeed in value based care

Quality Improvement
and Medical Policy

Optimize management of quality programs (Stars, HEDIS, etc.) purpose-built to line of business performance demands, and supported by medical policies that are grounded in evidence-based medicine and aligned to performance outcomes

Social Determinants
of Health

Align enterprise approaches to successfully address social determinants of health through purpose-built interventions and impactful community engagement

Utilization Management

Optimize programs to ensure medically necessary, care setting appropriate, high quality, and clinically optimal care delivery is delivered while minimizing member and provider abrasion

Value Based Care

Align incentives, design and execute win-win payer/provider contracts, and deploy enabling capabilities to ensure success in value-based care partnerships