managed care

AmeriHealth Caritas Louisiana is part of the AmeriHealth Caritas Family of Companies, a national leader in managed care. It provides access to quality health care to people covered by publicly funded programs, including Medicaid and the Louisiana Children's Health Insurance Program (LaCHIP). The company uses a coordinated approach to health care, leading-edge technology solutions, and innovative community programs, with the goal of improving health outcomes for members and building healthy communities across Louisiana.

behavioral health servicesclaims and billingcommunity health programspharmacy benefits managementpreventive careprior authorization

Aspira Health Global integrates digital health, care delivery, provider networks, analytics, research, and population health solutions within one connected healthcare ecosystem. It operates through seven interconnected business divisions offering healthcare technology, care delivery, provider services, management, analytics, research, and programs. Its Aspire Health Portal unifies Continuous Wellbeing Monitoring™, Measurement Based Care, personalized patient toolkits, health education, care navigation, and provider support.

AI-enabled solutionsclinical integrationdata integrationdigital health platformsdigital health validationEMR and clinical technology implementationhealthcare analyticshealthcare operationshealth portalsMobile Applicationspayer contractingpopulation healthprogram developmentproject managementreal world evaluationsoftware developmentstrategic-planningtechnology strategytelehealth

CCMSI is one of the nation's largest independent third-party administrators, providing comprehensive insurance and risk management services. For more than thirty years, the privately-held firm has delivered claims management, workers' compensation, property and casualty, managed care, and loss control solutions to clients.

claims managementergonomic assessmentlegal bill reviewloss controlproperty and casualty claims handlingprovider bill reviewregulatory compliance reviewrisk management information systemsutilization/disability managementworkers' compensation claims handling

CareSource Military & Veterans (CSMV) is a TRICARE contractor that administers the TRICARE Prime® Demo in Tampa, Florida, and Atlanta, Georgia, under contract with the Department of Defense. As part of a nonprofit managed care organization, CSMV provides dedicated care management support to help eligible military beneficiaries, retirees and their families navigate providers, benefits and care.

beneficiary servicescare management supportclaims paymentprovider network management

CareWorks has provided healthcare services since 2004 to companies and their employees, members of medical schemes, bargaining councils, life assurers and retirement funds, as well as community members. Services include comprehensive chronic disease management, prevention programmes, onsite and online health risk assessments and screening, and health education and training, with a national footprint of staff and contracted providers.

chronic disease managementclinical care coordinationcounselling serviceshealth education and trainingHIV prevention programmesonsite and online health risk assessmentsscreening

Anthem Blue Cross and Blue Shield HP is a managed care company offering Medicaid and low-cost insurance plans in New York, including coverage for low-income adults, pregnant women, children, and adults needing long-term care or behavioral healthcare.

behavioral healthcare coveragehealth insurancelong-term care services

Intercare has supported organizations for more than four decades with workers' compensation, liability, and clinical risk-management services. It pairs veteran adjusters and nurses with data and proven processes to lower total cost of risk for self-insured employers, pools, and captives. Services include custom claims administration, managed care, and risk management, with a focus on responsive service, transparent pricing, and measurable results.

claims administrationclaims managementclinical guidancecoverage analysisdata analysisevidence reviewsnegotiationon-site trainingrisk consulting