Careradius - Single integrated care management solution

CareRadius™

Looking and going deeper with a single integrated care management solution

CareRadius™

Looking and going deeper with a single integrated care management solution

Integrated and analytic-driven care management driving higher quality and cost outcomes

Our flagship CareRadius™ platform enables healthcare payers in effectively managing their patients’ health under the realities of the new value-based market.

An integrated care management platform informed with analytics and driven by advanced digital and automation technologies, CareRadius™ enables transparency across the care continuum, giving health plans quick and seamless access to real-time data that enhances clinical decision making, drives quality, improves workflows, reduces administrative costs, and enables effective medical cost management.

This single, integrated platform helps health plans manage all care management functions, including utilization management and case management within a population health framework.

All about CareRadius™

CareRadius™ is a highly flexible and configurable platform that provides health plans the opportunity to leverage standard or custom workflows and rules based on the needs of their organization. The platform’s out-of-the box capabilities enable health plans to meet all regulatory, accreditation and audit standards for easy and streamlined compliance.

The platform works smarter to make sense of the data. Using an omnichannel approach, the platform gathers effective insights from the captured data – like provider behavior, overturned clinical decisions, network adequacy, engagement with care programs, RX compliance, and more – to ensure health plans reach members at the right time, with the right message, over the right channel, and achieve the best possible outcomes.

Proven outcomes

CareRadius™ has delivered proven, outstanding results across all care management functions:

  • Average years as a customer 6+
  • Engagement Improved by 27% for case management
  • Engagement Improved by 38% for chronic disease management
  • Meeting target turn-around times 95% for utilization management
Featured insights
The platform enables transparency across the care continuum, giving health plans quick and seamless access to real-time data that enhances clinical decision-making, drives quality, improves workflows, reduces administrative costs, and enables effective medical cost management.
A large, regional U.S. health plan with $2.6 billion in revenue interacts with various audiences such as employer groups, regulatory agencies, healthcare practitioners, and more than 600,000 members including those who are insured through employer groups, self-insured, or on Medicare Advantage or Medicaid.
A large national healthcare insurer was looking to take their Utilization Management (UM) operations to the next level. They sought a strategic partner that would bring innovations, efficiencies and savings to their organization and help them deliver continuous process improvements.