Utilization Management Companies

Easily navigate the crowded vendor landscape

Utilization management companies manage the cost of care, particularly in healthcare, evaluating the medical necessity, appropriateness, and efficiency of healthcare services.

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Rachel B

HR Director

Vendor Banner Utilization Management Companies Q1  2024

Q1 March 2024: Winners

Top 8 Utilization Management Companies

List of the top 8 Utilization Management Companies in Shortlister as of March 2024, presented in the order they appear in the full Vendor Listing tab.

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49 Vendors
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Full Reviews Breakdown

Conifer Health Solutions

Our Utilization Management program is delivered by licensed Utilization Management Nurses (UMN) and positions our clients to not only focus on cost containment, but also their members’ access to the right care, in the right setting, at the right time. Our ... View Full Profile

Employees
455
Lives Serviced
1,000,000
Funding
None
Minimum Group Size
No Minimum
Features
3rd Party Integrations
NCQA Accredited / Certified
SSAE 18 / SOC Audit(s) Performed
Top Offerings
Utilization Management
Chronic Condition / DM
Patient Case Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

American Health Holding, Inc.

Founded in 1993 as a privately held company, American Health Holding provides comprehensive, integrated health management solutions through a team of highly qualified physicians, registered nurses and social workers with the training and tools to impact ... View Full Profile

Employees
Not Provided
Lives Serviced
2,500,000
Funding
Minimum Group Size
1 eligible
Features
3rd Party Integrations
Global Capabilities
Responsive Design
Top Offerings
Utilization Management
Patient Case Management
Chronic Condition / DM
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.5 (1 reviews)
Full Reviews Breakdown

Quantum Health

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 part of its core care coordination and navigation ... View Full Profile

Employees
1800
Lives Serviced
2,700,000
Funding
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Clinical Navigation / Care Coordination
Benefits Navigation Platform
Utilization Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
5.0 (2 reviews)
Full Reviews Breakdown

Telligen

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 need it. -Eliminate ... View Full Profile

Employees
600
Lives Serviced
600,000
Funding
Angel Round
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Chronic Condition / DM
Patient Case Management
Utilization Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.4 (29 reviews)
Full Reviews Breakdown

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 ... View Full Profile

Employees
210
Lives Serviced
350,000
Funding
None
Minimum Group Size
50 eligible
Features
3rd Party Integrations
Android Native Application
Dashboard analytics
Top Offerings
Wellness Platform
Chronic Condition / DM
Benefits Navigation Platform
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.0 (1 reviews)
Full Reviews Breakdown

ActiveHealth Management

Our advocacy-driven utilization management program can help clients lower health care costs, improve health outcomes and increase member satisfaction. When you work with us, you can: • Reduce unnecessary utilization - Practitioners can serve differing ... View Full Profile

Employees
900
Lives Serviced
32,000,000
Funding
None
Minimum Group Size
1500 eligible
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Health Coaching
Wellness Platform
Utilization Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -

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Reviews pending
Full Reviews Breakdown

Mobile Health

Employees
350
Lives Serviced
4,000,000
Funding
1 Angel Round
Minimum Group Size
1 eligible
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Wellness Platform
Benefits Navigation Platform
Incentive Fulfillment
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.1 (5 reviews)
Full Reviews Breakdown

Sharecare

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 ... View Full Profile

Employees
3628
Lives Serviced
14,300,000
Funding
39B Post-IPO Equity
Minimum Group Size
1000 eligible
Features
3rd Party Integrations
Android Native Application
Full CDC Recognition for DPP
Top Offerings
Wellness Platform
Benefits Navigation Platform
Clinical Navigation / Care Coordination
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

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, ... View Full Profile

Employees
Not Provided
Lives Serviced
11,500
Funding
Minimum Group Size
100 eligible
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Chronic Condition / DM
Health Coaching
Behavioral Health Access & Treatment
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.1 (39 reviews)
Full Reviews Breakdown

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... View Full Profile

Employees
90
Lives Serviced
2,100,000
Funding
None
Minimum Group Size
50 eligible
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Wellness Platform
Corporate Wellness Consultants
Health Coaching
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
3.2 (11 reviews)
Full Reviews Breakdown

PlanSource

PlanSource automates and streamlines every aspect of employee benefits programs, so HR teams can spend less time on ben admin tasks and more time where it really matters. Our powerful platform configurability, strong industry partnerships and relentless ... View Full Profile

Employees
Not Provided
Lives Serviced
5,500,000
Funding
Not Provided
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Dashboard analytics
Employee self-service
Top Offerings
Benefits Administration
Employee Engagement Platform
ACA Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Privia Health

Privia Health is a national medical group that supports employers with a Physician-Led Platform which utilizes the trusted employee-physician relationship to derive higher employee engagement in health management programs and tailors virtual capabilities to ... View Full Profile

Employees
Not Provided
Lives Serviced
3,000,000
Funding
450M Post-IPO Equity
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Primary Care – Virtual Care
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
3.6 (5 reviews)
Full Reviews Breakdown

US Wellness

One Vendor. Many Solutions. Custom Programs. • Proven Results - as a leader in the wellness industry for two decades we provide measurable outcomes to organizations across the country. • Dedicated Account Team - our team is an extension of your team - ... View Full Profile

Employees
45
Lives Serviced
1,000,000
Funding
Not Provided
Minimum Group Size
100 eligible
Features
3rd Party Integrations
Android Native Application
Full CDC Recognition for DPP
Top Offerings
Biometric Screenings
Wellness Platform
Health Coaching
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Carrot Fertility

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, gender identity, marital status, ... View Full Profile

Employees
400
Lives Serviced
2,000,000
Funding
200K Series C
Minimum Group Size
50 eligible
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Infertility & Egg Freezing
Adoption & Surrogacy
Clinical Navigation / Care Coordination
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

OnSite Health

Since 2005, OnSite Health has been the on-site health care provider of choice for nearly 200 employers from all categories of industry to enable and maintain a healthier and more productive workforce, mitigate costly insurance claims, aid in early disease ... View Full Profile

Employees
100
Lives Serviced
9,132
Funding
Not Provided
Minimum Group Size
1 eligible
Features
3rd Party Integrations
Responsive Design
SSAE 18 / SOC Audit(s) Performed
Top Offerings
Primary Care – Employer Health Clinic
Biometric Screenings
Health Coaching
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Kannact Inc

Kannact offers a highly vetted, culturally sensitive certified coach-led population health management program guaranteed to improve measurable outcomes across three pillars: preventive health, mental health, and chronic care management. On day one, group ... View Full Profile

Employees
40
Lives Serviced
135,000
Funding
1.4M Angel Round
Minimum Group Size
1000 eligible
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Health Coaching
Chronic Condition / DM
Behavioral Health Access & Treatment
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
5.0 (1 reviews)
Full Reviews Breakdown

League

Through partner(s... View Full Profile

Employees
500
Lives Serviced
1,200,000
Funding
95M Series C
Minimum Group Size
100 eligible
Features
3rd Party Integrations
Android Native Application
Global Capabilities
Top Offerings
Benefits Navigation Platform
Wellness Platform
Healthcare Transparency Solutions
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Cigna

Our mission is to improve the health, well-being and peace of mind of those we serve by providing support and being with them every step of the way. Any marketing information on this page is not intended for residents of New Mexico... View Full Profile

Employees
Not Provided
Lives Serviced
Not Provided
Funding
Not Provided
Minimum Group Size
No Minimum
Features
Top Offerings
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

FitOn Health (Formerly Peerfit, Inc.)

FitOn Health is the leading enterprise health and wellness platform. We provide whole-health solutions such as condition-management courses, and instant access to the widest variety of workout and meditation classes from world-class trainers, experts and ... View Full Profile

Employees
75
Lives Serviced
16,000,000
Funding
Not Provided
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
Global Capabilities
Top Offerings
Gym Networks
On-demand Fitness Content
Nutrition
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
3.1 (6 reviews)
Full Reviews Breakdown

Sterling Wellness Solutions, L.L.C.

Our mission: Sterling Wellness Solutions is committed to positively affecting the health and wellbeing of workplace populations to impact the productivity and success of our client companies. As the friendliest, most dedicated partner in workplace wellbeing, ... View Full Profile

Employees
200
Lives Serviced
100,000
Funding
None
Minimum Group Size
300 eligible
Features
3rd Party Integrations
Android Native Application
Full CDC Recognition for DPP
Top Offerings
Wellness Platform
Chronic Condition / DM
Biometric Screenings
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -