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

From Regulation to Reckoning: Decoding CMS Prior Authorization in 2026

CMS expects tangible operational change under the authorities and commitments already in place, rather than prolonged debate over additional regulatory interventions. Klomp acknowledged that CMS has limited additional regulatory authority across Medicare, Medicaid, and commercial markets.1 The framework has been set. The focus now rests on implementation and execution. Are prior authorization requirements making a difference?

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Blogs

How Automation Is Reshaping Utilization Management & Prior Auth Workflows

Prior authorization has been a central component of utilization management for decades. Health plans rely on the process to evaluate medical necessity, manage costs, and maintain appropriate care delivery. At the same time, the administrative burden tied to prior authorization has grown steadily as documentation requirements, clinical criteria, and regulatory expectations have expanded. Within utilization management programs, automation is reshaping case routing, staffing models, clinical review processes, and governance practices. For health plans with established UM operations, the primary consideration today is how automation fits into the broader operating model for prior authorization.

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End-to-End Managed Care Consulting Services

Clinical Management Services

Operational Management Services

Expert Insights

Innovative Processes

Comprehensive Solutions

The Clearlink Way

Discovery

Analysis

Strategy

Delivery

Optimization

Empowering Effective D-SNP Case Management

Expert
Insights

Innovative
Processes

Comprehensive
Solutions