End-to-End Managed Care Consulting Services

We help healthcare organizations manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity.

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Clinical Management Services

Identify opportunities to adopt transformational and holistic clinical solutions, even for the most complex populations. Generate best-in-class outcomes, decrease spend, and continually accelerate financial performance.

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Operational Management Services

Achieve optimal performance by successfully navigating and managing the complex operational, financial, and technological functions and activities of a constantly shifting healthcare environment. Become more equipped to stay agile with solutions that offer effective program and project management, system optimization, data-driven innovation, and cross-departmental alignment.

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Expert
Insights

Innovative
Processes

Comprehensive
Solutions

We engaged Clearlink to benefit from their national perspective, understanding of industry benchmarks, and experience with other health care organizations – especially Medicare Managed Care Organizations – to improve care management for our members. Our work with Clearlink allowed us to assess and implement opportunities for improvement while we continued to manage business as usual.

Marylou Buyse M.D., former Chief Medical Officer, Neighborhood Health Plan of Rhode Island

“Clearlink brought our vision to life, developing data-driven reports that support the review of services in our prior authorization program and established a dedicated committee to review best practices in prior authorization. With their support, we are prepared for the future, ensuring high-quality, cost-effective care for our members while minimizing provider and member abrasion.”

KRISTIN POTH, AVP, JOHNS HOPKINS HEALTH CARE (JHHC)

The Clearlink Way

How we develop tailored, end-to-end programs that successfully manage healthcare spend, achieve accelerated operational efficiency, and serve more members with higher quality, equitable care.

Experience our 5-Step Process

Discovery

We begin with an in-depth review of your existing processes, including relevant programs, policies, workflows, contracts, KPIs, and business systems. Then we discuss the biggest challenges you currently face and the goals you have for growth.

Analysis

We evaluate your performance against industry standards, accreditation needs, contractual compliance demands, and regulatory requirements applicable to your business model and share a preliminary plan for addressing identified gaps.

Strategy

We build and finalize a custom program and implementation timeline using select services from our suite of clinical and operational solutions. This includes intended project tactics, key performance metrics, and projected results.

Delivery

We execute your strategic program through a dedicated team of specialized consultants who work as an extension of your organization to deliver comprehensive solutions and expertise with full lifecycle support.

Optimization

We continue to optimize your program to meet new needs and achieve efficiencies at the enterprise and operational level. We remain focused on helping your organization maintain sustainable processes and navigate change.

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Blogs

PCCP for Payer AI: Governing UM & Claims Model Updates in 2026

Most health plans have moved past debating whether artificial intelligence belongs in utilization management and claims operations. The harder question is how to manage change. UM and claims models retrain, recalibrate, and adjust as policies shift, data changes, and performance issues surface. Yet governance structures often assume stability. That mismatch is now one of the most common sources of compliance risk for payer AI.

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