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.

"Shortlister saved us time and money, while helping us to identify a platform that fit our unique company culture."

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Rachel B

HR Director

Vendor Banner Utilization Management Companies Q2  2024

Q2 May 2024: Winners

Top 4 Utilization Management Companies

List of the top 4 Utilization Management Companies in Shortlister as of May 2024, presented in the order they appear in the full Vendor Listing tab.

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45 Vendors
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Full Reviews Breakdown

Conifer Health Solutions

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 right setting, at the right time. Our holistic... View Full Profile

Employees
455
Lives Serviced
1,000,000
Funding
None
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Utilization Management
Chronic Condition / DM
Patient Case Management
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
None
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
None
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Utilization Management
Patient Case Management
Chronic Condition / DM
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
4.0 (1 reviews)
Full Reviews Breakdown

ActiveHealth Management

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 ... 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
Wellness Platform
Health Coaching
Utilization Management
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
3.2 (11 reviews)
Full Reviews Breakdown

PlanSource Benefits Administration, Inc.

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

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
- - -

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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
- - -
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
Maternity (Clinical)
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
Clinical Navigation / Care Coordination
Chronic Condition / DM
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

Milu Health

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 their EHR data. Milu offers ... View Full Profile

Employees
7
Lives Serviced
Not Provided
Funding
Not Provided
Minimum Group Size
No Minimum
Features
GDPR Compliant
SOC audit(s) performed
SSAE 18 / SOC Audit(s) Performed
Top Offerings
Benefits Decision Support
Fraud, Waste & Abuses
Healthcare Transparency Solutions
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
- - -
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
- - -
Reviews pending
Full Reviews Breakdown

Health Solutions LLC

Health Solutions’ passion is our participants. We want them to be healthier and more productive—so they can live their best life. Our clinical pharmacists and health educators provide one-on-one health coaching for participants who are working to maintain... View Full Profile

Employees
Not Provided
Lives Serviced
27,000
Funding
Not Provided
Minimum Group Size
1 eligible
Features
3rd Party Integrations
GDPR Compliant
Responsive Design
Top Offerings
Chronic Condition / DM
Health Coaching
Diabetes
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Lyn Health

We work with employers to offer Lyn to employees living with multiple chronic conditions. Once enrolled with Lyn, we provide: virtual primary care and urgent care care coordination, navigation and advocacy medication management integrated behavioral health ... View Full Profile

Employees
35
Lives Serviced
1
Funding
Not Provided
Minimum Group Size
No Minimum
Features
Responsive Design
Top Offerings
Chronic Condition / DM
Clinical Navigation / Care Coordination
Behavioral Health Access & Treatment
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

SentryHealth

SentryHealth is a clinical-first care navigation company that combines data science, technology, and an experienced care team to match members with the best available health care. It blends expert guidance with personalized care plans, empowering members to ... View Full Profile

Employees
103
Lives Serviced
72,868
Funding
None
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Clinical Navigation / Care Coordination
Patient Advocacy
Health Coaching
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

Hines

Employees
Not Provided
Lives Serviced
Not Provided
Funding
Not Provided
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Patient Case Management
Utilization Management
Reference Based Pricing (RBP)
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

Strive Health

Strive is a value based kidney care provider that deploys a high-touch care anytime care anywhere (virtual, in-home, in-clinic) model to slow or halt the progression of CKD; optimize the transition to ESRD; and improve the health and quality of life for ... View Full Profile

Employees
473
Lives Serviced
55,000
Funding
220M Series B
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
iOS Native Application
Top Offerings
Chronic Condition / DM
Complex or Rare Conditions
Clinical Navigation / Care Coordination
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -
Reviews pending
Full Reviews Breakdown

WINFertility

WINFertility specializes in fertility and family wellbeing management, offering a comprehensive care management model which combines all aspects of medical and pharmacy infertility and family building care management. Treatment solutions can be delivered using... View Full Profile

Employees
7400000
Lives Serviced
150,000
Funding
None
Minimum Group Size
No Minimum
Features
3rd Party Integrations
Android Native Application
GDPR Compliant
Top Offerings
Clinical Navigation / Care Coordination
Infertility & Egg Freezing
Patient Advocacy
Average Cost
- - -
Key Clients
- - -
Clients Your Size
- - -