Utilization Management Companies

Product Info

Min. Group Size

1,000 eligible

Lives Serviced

1,500,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Our Utilization Management program is delivered by licensed Utilization Management Nurses and positions our clients to not only focus on cost containment, but also their members’ access to the right care, in the... Show More

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Quantum Health

4.5 (1)

Product Info

Min. Group Size

1,000 eligible

Lives Serviced

2,700,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

The healthcare environment is complex, and determining what is covered, as well as how best to adhere to a treatment plan, can be challenging for consumers. Quantum Health offers utilization management (UM) as... Show More

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Top Vendor

Telligen

5.0 (2)

Product Info

Min. Group Size

500 eligible

Lives Serviced

600,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Telligen's Utilization Management program makes sure your members get the evidence-based medical care they need. Telligen's utilization management program is designed to:
-Ensure high quality care is delivered to those who medically... Show More

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Personify Health

4.0 (98)

Product Info

Min. Group Size

1,000 eligible

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Personify Health’s URAC-accredited Utilization Management Department performs prior authorization/precertification reviews to ensure medical necessity. We offer a customizable prior authorization/precertification list that can be personalized to your clients’ needs.

Clinicians... Show More

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ActiveHealth Management

4.0 (1)

Product Info

Min. Group Size

1,500 eligible

Lives Serviced

3,800,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

ActiveHealth’s Utilization Management program underscores the importance of providing evidence-based healthcare services designed to safeguard optimal health outcomes while controlling costs. Our staff of registered nurses and physicians support both participants and their... Show More

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Wellworks For You

4.1 (39)

Product Info

Company Overview

Founded

2008-06-01

Employees

115

Funding Summary

None

Clients Your Size

About Wellworks For You

Wellworks For You provides wellness services to companies of all sizes, governments, resellers, and individuals throughout the world.

Wellworks For You was created as a vehicle to assist employers in designing and implementing a comprehensive wellness program. We recognize that healthy minds and healthy bodies are the catalyst to a successful working environment.

Corporate wellness programs have a proven track record of Return on Investment (ROI). The pitfall of many programs is that they are still one-dimensional, not personalized, and passive with minimal participation. The Wellworks For You Program commits to a strong focus... Show More

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Carrot Fertility

Reviews pending

Product Info

Min. Group Size

50 eligible

Lives Serviced

2,000,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Carrot does not offer traditional utilization management (UM) services. The Carrot benefit was designed with inclusivity at its core, allowing all access to the benefit regardless of age, race, income, sex, sexual orientation,... Show More

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Top Vendor

HealthCheck360

4.4 (29)

Product Info

Company Overview

Founded

1994

Employees

210

Funding Summary

None

Clients Your Size

About HealthCheck360

At HealthCheck360, we turn our passion into your program. We’re leaders in population health management and well-being solutions. Our services are like a choose your own adventure book. Select the options you need to fill gaps in your current benefits or create a comprehensive program to fit your organization’s unique culture. We can even work with your brokers, third party administrator, insurance companies or other benefit provider for a complete integration of services. Show More

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MedWatch, LLC

Reviews pending

Product Info

Min. Group Size

1 eligible

Lives Serviced

383,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Since 1988, MedWatch’s URAC-accredited Utilization Management has been continually evolving and provides a process that is both efficient and effective in identifying appropriateness of care and opportunities for significant cost savings. The precertification... Show More

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Sterling Wellness Solutions, L.L.C.

3.1 (6)

Product Info

Company Overview

Founded

2001

Employees

50

Funding Summary

None

Clients Your Size

About Sterling Wellness Solutions, L.L.C.

At Sterling Wellness Solutions, we believe that health and well-being are the foundation for a fulfilling life. Our total approach to employee wellbeing provides innovative and personalized solutions that empower individuals and organizations to achieve their health goals. We are committed to a holistic approach that considers the physical, mental, and emotional aspects of health, and we believe that preventive care is key to a healthy lifestyle. Our values of integrity, empathy, collaboration, and innovation guide us as we create a culture of wellness that inspires individuals to take control of their health. With our expertise and support, we strive... Show More

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US-Rx Care

Reviews pending

Product Info

Company Overview

Founded

01/2007

Employees

200

Funding Summary

Not Provided

Clients Your Size

About US-Rx Care

In contrast to traditional PBM service providers, US-Rx Care operates with full transparency and without any conflicts of interest, backed up by ERISA-defined fiduciary commitments in our service contract. Our fiduciary pharmacy benefits management services deliver unprecedented drug cost savings to self-insured employers, union trusts, and health plans. Typical client savings range from 30%-50% in total drug and administrative cost versus their previous PBM service provider within the first 12 months of US-Rx Care service. Member out-of-pocket costs drop 30% or more also with no change in benefit design. Show More

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ClaimChoice Administrators

Reviews pending

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

ClaimChoice Utilization Management is designed to enhance healthcare outcomes, manage costs, and ensure the highest quality of care for patients. Our platform provides real-time insights and data-driven decision-making tools to streamline the utilization... Show More

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League

5.0 (1)

Product Info

Min. Group Size

100 eligible

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Through partner(s). Show More

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AlbumHealth

Reviews pending

Product Info

Company Overview

Founded

2013

Employees

Funding Summary

Clients Your Size

About AlbumHealth

Album's vision has always been to support people with chronic disease by changing their behavior. Supported by over a decade of research and clinical outcomes, we set out to prove it in a large employer setting in 2015.....and did. Now we're engaging payers, providers , and employers in the critical discussion around how to support the highest cost portion of their population. Show More

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Milu Health

Reviews pending

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Milu's BenefitMatcher product identifies opportunities for employees to utilize existing employee benefits & notifies them in real time. Members will be notified when the opportunity to utilize a potential benefit is detected in... Show More

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Sharecare

4.1 (5)

Product Info

Min. Group Size

5,000 eligible

Lives Serviced

2,000,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Sharecare offers Utilization Management through our Clinical Advocacy program. We partner with American Health (AHH) for utilization management. AHH's URAC-accredited Utilization Management program is based on: timely review and determination of clinical eligibility... Show More

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Corporate Care Management

Reviews pending

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Corporate Care Management is URAC accredited in Health Utilization Management. Health Utilization Management (HUM) provided by CCM supports the delivery of quality medical care and patient safety by evaluating for medical necessity, appropriateness,... Show More

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Hines

Reviews pending

Product Info

Company Overview

Founded

Employees

Funding Summary

Not Provided

Clients Your Size

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WINFertility

Reviews pending

Product Info

Company Overview

Founded

1997

Employees

220

Funding Summary

None

Clients Your Size

About WINFertility

WIN is the nation’s leading family-building and family well-being benefit company. Since its founding in 1997, WIN has continually expanded and enhanced its omnichannel solutions to address the individual and family needs through every stage of life—pre-conception, fertility, adoption and surrogacy, maternity, parenting, menopause, women’s health, and beyond.

WIN’s flexible solutions are offered directly to employers or via health plan integrations. More than 900 highly diverse clients and 9+ million members trust WIN because of our demonstrated capability to address needs across all funding types, industries, businesses, member demographics, geographies, and integrated partner solutions.
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PlanSource Benefits Administration, Inc.

3.2 (11)