Utilization Management Companies

Utilization management companies manage the cost of care, particularly in healthcare, evaluating the medical necessity, appropriateness, and efficiency of healthcare services.
  • All Vendors (70)
  • Top Vendors (4)
Sort by:
Sponsored sort by
Conifer Health Solutions

Conifer Health Solutions

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

1,000 eligible

Lives Serviced

1,500,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Our Utilization Management (UM) program is delivered by licensed UM 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
Company Overview
Top Vendor
Telligen

Telligen

5.0 (2)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

500 eligible

Lives Serviced

600,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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
Company Overview
Quantum Health

Quantum Health

4.3 (3)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

500 eligible

Lives Serviced

3,100,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Quantum Health delivers utilization management through dedicated Pre-Certification and Utilization Review Nurses embedded in each Pod. Pre-certification acts as an early touchpoint, enabling proactive engagement for care coordination, case management, and in-network redirection.... Show More
Company Overview
Personify Health

Personify Health

4.0 (104)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

1,000 eligible

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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 clients' needs.

Clinicians also... Show More
Company Overview
ActiveHealth Management

ActiveHealth Management

4.0 (1)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

1,500 eligible

Lives Serviced

3,800,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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
Company Overview
Wellworks For You

Wellworks For You

4.1 (43)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

50 eligible

Lives Serviced

139,500

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Not currently available with Wellworks For You. Show More
Company Overview
MedWatch, LLC

MedWatch, LLC

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

1 eligible

Lives Serviced

383,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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
Company Overview
Top Vendor
HealthCheck360

HealthCheck360

4.3 (31)
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

1994

Employees

210

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

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
Inclusively

Inclusively

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Inclusively’s Retain platform transforms everyday employee interactions with HR systems into powerful, anonymized insights. It maps what employees are actually searching for—benefits, wellness programs, services, technologies, accommodations—against what companies already offer, revealing gaps... Show More
Company Overview
Vālenz Health

Vālenz Health

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

2007

Employees

200

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

About Vālenz Health

Vālenz (VAY-lens) Health® is the platform to simplify healthcare: the destination for members, employers, payers, and providers to reduce costs, improve quality, and elevate the healthcare experience.

Our mission? To optimize the cost, quality, and utilization of healthcare for everyone with a fully integrated solution suite that executes across the entire patient journey, from member experience to payment integrity, provider quality, and plan performance.

With America’s largest cost, quality and utilization dataset, we create greater transparency, flexibility, and cost containment — empowering members and customers with the information they need to engage early and... Show More
League

League

5.0 (1)
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

100 eligible

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Through partner(s). Show More
Company Overview
SlateRx

SlateRx

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

Employees

130

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

About SlateRx

SlateRx has been listening to what employers, plan sponsors, and brokers have been saying about traditional pharmacy benefit management—it’s time for something new. We provide a pharmacy benefit experience that puts you in control. Introducing PBX by SlateRx.

With deep actuarial, clinical, and operations experience, our ability to deliver results means unmatched value. With this proven expertise, we create innovative solutions that optimize medication access, improve health outcomes, and control costs. Our commitment to transparency and collaboration is at the core of our approach, ensuring clear communication and empowering informed decision-making.

We live... Show More
AlbumHealth

AlbumHealth

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

2013

Employees

0

Funding Summary

Angel Round

Clients Your Size Clients Your Size

Clients size is Locked

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
ClaimChoice Administrators

ClaimChoice Administrators

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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
Company Overview
Healthboxed

Healthboxed

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

2019

Employees

4

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

About Healthboxed

Each HealthBox includes a curated selection of wellness products that align with the client’s chosen wellness theme and may also feature custom-printed materials such as an EAP flyer, open enrollment information, or other wellness resources. Our themed boxes cover topics like Open Enrollment, Mental Health, Healthy Eating, Exercise, Stress Relief, and more, with all orders custom-priced based on the client’s wellness fund budget. The minimum budget is $22 per employee (all-inclusive, flat fee), though most clients allocate between $30–$60 per employee, and there is a minimum overall spend of $3,000 per order with no minimum quantity required. Boxes can be... Show More
Sterling Wellness Solutions, L.L.C.

Sterling Wellness Solutions, L.L.C.

3.1 (6)
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

2001

Employees

50

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

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 accountability 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
US-Rx Care

US-Rx Care

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

01/2007

Employees

200

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

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
Corporate Care Management

Corporate Care Management

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

0 Specific Questions Specific Questions

Lock

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
Company Overview
Hines

Hines

Reviews pending
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

Employees

0

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked
PlanSource Benefits Administration, Inc.

PlanSource Benefits Administration, Inc.

3.3 (12)
Visit Profile
View Profile
Select Vendor to Compare
Product Info
Company Overview

Founded

2008

Employees

650

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

About PlanSource Benefits Administration, Inc.

Founded in 2008, PlanSource is a benefits administration company on a mission to make it easier for people to choose, use, and manage benefits through engaging, AI-powered experiences. PlanSource solves even the most complex benefits challenges for thousands of customers by pairing a comprehensive suite of strategic administration services with a modern and highly configurable platform. Leading the market in meaningful integration of AI, PlanSource has an unmatched range of ecosystem connections that drive continual innovation and value to clients, partners, and consumers. Headquartered in Orlando, Florida, PlanSource supports more than 5 million consumers through partnerships with more than 3,400 employers... Show More

Select up to 3 Vendors to Compare

×