Utilization Management Companies

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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Conifer Health Solutions

Conifer Health Solutions

Reviews pending
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Min. Group Size

1,000 eligible

Lives Serviced

1,500,000

Average Cost

Average Cost is Locked

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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

Quantum Health

4.5 (1)
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Min. Group Size

1,000 eligible

Lives Serviced

2,700,000

Average Cost

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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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Telligen

Telligen

5.0 (2)
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Min. Group Size

500 eligible

Lives Serviced

600,000

Average Cost

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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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ActiveHealth Management

ActiveHealth Management

4.0 (1)
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Min. Group Size

1,500 eligible

Lives Serviced

3,800,000

Average Cost

Average Cost is Locked

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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

Wellworks For You

4.1 (39)
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Company Overview

Founded

2008-06-01

Employees

90

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

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
Carrot Fertility

Carrot Fertility

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Min. Group Size

50 eligible

Lives Serviced

2,000,000

Average Cost

Average Cost is Locked

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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

HealthCheck360

4.4 (29)
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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
Hines

Hines

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Founded

Employees

Funding Summary

Not Provided

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League

League

5.0 (1)
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Min. Group Size

100 eligible

Lives Serviced

-

Average Cost

Average Cost is Locked

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Product Description

Through partner(s). Show More
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MedWatch, LLC

MedWatch, LLC

Reviews pending
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Company Overview

Founded

1988

Employees

365

Funding Summary

Not Provided

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About MedWatch, LLC

Established in 1988, MedWatch is a proven industry leader providing population health management and cost containment services nationwide to a wide variety of clients including TPAs, MGUs, stop loss carriers, employers, schools, hospital systems, Taft Hartley plans and fully insured payers.

MedWatch’s core services include Utilization, Case, and Disease Management which provide early identification, management and mitigation of the health and financial risks for our clients and plan members.

To address the ever-increasing list of costly pharmaceuticals that are available and prescribed today, MedWatch has an on-staff PharmD who is dedicated to... Show More
Milu Health

Milu Health

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

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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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PlanSource Benefits Administration, Inc.

PlanSource Benefits Administration, Inc.

3.2 (11)
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Company Overview

Founded

2008

Employees

Funding Summary

Not Provided

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Clients size is Locked

About 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 commitment to creating wildly successful customers is why more than 5,000 employers and 7.5 million consumers trust PlanSource for their benefits. Show More
SentryHealth

SentryHealth

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Company Overview

Founded

2011

Employees

103

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About 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 make more informed decisions while connecting them to high-quality, low-cost care. From virtual health coaching to locating high-quality providers to managing complex medical conditions and prescription drugs, the company drives smarter utilization of benefits, better outcomes, and real cost savings. Show More
Sterling Wellness Solutions, L.L.C.

Sterling Wellness Solutions, L.L.C.

3.1 (6)
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Founded

2001

Employees

200

Funding Summary

None

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About 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, we work with organizations to develop strategies that inspire healthy change, maximize engagement, and transform company culture. Show More
AlbumHealth

AlbumHealth

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Founded

2013

Employees

Funding Summary

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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
Sharecare

Sharecare

4.1 (5)
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Product Info

Min. Group Size

5,000 eligible

Lives Serviced

100,000

Average Cost

Average Cost is Locked

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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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WINFertility

WINFertility

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Company Overview

Founded

1997

Employees

7,400,000

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About 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 WIN’s provider network or integrated with an employer’s chosen health insurance carrier. Both models connect patients to the highest quality providers and the most successful protocols. In addition, our prior authorization program provides dosing and formulary management for all fertility related drugs, driving efficiency and cost savings.
Throughout the entire family-building process, WINFertility provides inclusive advocacy and care. In addition to a customer service representative,... Show More
Accolade

Accolade

Reviews pending
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Product Info

Min. Group Size

500 eligible

Lives Serviced

-

Average Cost

Average Cost is Locked

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Product Features

Not Provided.

Product Description

Accolade is the single point of contact for both members and providers. We support electronic or telephonic submission of medical prior authorizations or pre-certifications. The complete Utilization Management (UM) process includes precertification, continued... Show More
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Grokker

Grokker

4.4 (11)
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Company Overview

Founded

06/2012

Employees

25

Funding Summary

30M Series B

Clients Your Size Clients Your Size

Clients size is Locked

About Grokker

Grokker is a global wellness vehicle that fuels wellbeing in emotional, financial, physical, and social health. We are the engine behind today's most successful US-based, and Global companies. Our patented visual experiences offer your client's employees deep expertise, twenty four hour availability, and current content. What's more is that our experiences can be stored. If your client's employee wants to return back to an emotional, financial, physical, or social health experience that worked, they can do so at anytime and from anywhere. And that's not all. Our visual experiences also include Group Guides features. Grokker Guides (a three steps a... Show More
HealthWell Solutions

HealthWell Solutions

Reviews pending
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Founded

2009

Employees

Funding Summary

Not Provided

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About HealthWell Solutions

HealthWell Solutions is a health management company that provides customized, evidence-based solutions to drive successful health outcomes. We start by taking the time to get to know our clients and their unique needs. We believe that no single solution is the best fit for every group. The HealthWell Solutions team will design a customized plan that incorporates your existing resources, identifies needs for new programs and delivers the most innovative tools for comprehensive population health with superior service.

HealthWell Solution’s nationwide, credentialed staff implements high-touch programs that motivate behavior change while utilizing next-generation technology solutions to engage... Show More

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