Clinical Management Solutions
Maximizing quality care, achieving compliance and proactively driving performance acrossall core components of healthcare organization’s medical management and population health strategies.
An integrated clinical management program is essential for health plans to guide members to the right care, at the right time, while accelerating financial and operational improvements. Clearlink’s experienced team partners with your organization to evaluate and assess current clinical management processes and help to enhance programs with individualized, effective strategies.
Solutions for Improved Clinical Outcomes
Transformation in the healthcare industry requires agility, innovative thinking, and a readiness to make meaningful change for the benefit of members. With that in mind, Clearlink’s vision is to deliver optimized, end-to-end clinical management programs that take a wholistic view across care management, utilization management, compliance & regulatory, member & provider satisfaction, business intelligence & analytics, and supporting system initiatives.
CARE
MANAGEMENT
& PROGRAM
DESIGN
Design your care model, clinical programs and targeted interventions to the populations, products and markets you serve to ensure engagement and management of the right members.
MEDICAL COST
CONTAINMENT
& UTILIZATION
MANAGEMENT
Evaluate your data and trends to identify key drivers of cost and manage what matters, ensuring care for the right members at the right time and in the right place. Expedite access for necessary care and consider lower-cost alternatives, when appropriate.
POPULATION
HEALTH
MANAGEMENT
Improve the health and wellbeing of defined populations and subpopulations. Take a holistic approach delivered through a tailored care model with targeted programming that improves engagement in integrated, coordinated care aligned to improved outcomes and financial incentives and rewards.
SOCIAL
DETERMINANTS
OF HEALTH
Evaluate and understand the environmental (social, physical, etc.) risk factors that impact the populations you serve to design or connect to integrated programs, resources and approaches that can be leveraged to remove obstacles and enable efforts to address health disparities and promote health equity.
REGULATORY
COMPLIANCE &
ACCREDITATION
Assess, monitor and improve ongoing performance to ensure compliance with requirements and adherence to standards to decrease risk for the organization. Pursue and leverage accreditation to document high quality and provide evidence of how your organization is performing compared to industry standards and benchmarks.
QUALITY &
PERFORMANCE
IMPROVEMENT
Manage ongoing performance against key metrics and benchmarks to drive improved outcomes, create value for key stakeholders, capture at risk revenue and achieve financial incentives in a sustainable model that demonstrates continuous improvement and supports achievement of organizational goals and targets.
CLINICAL
APPLICATION
DESIGN &
INTEGRATION
Assess the needs of the organization to vet and select key functional platforms and leverage expertise to support design planning to optimize system value, streamline workflows, eliminate duplication, integrate data, automate process, deliver reporting and achieve crossfunctional transparency.
Accelerate your Clinical Management Strategy Forward
Clearlink’s Opportunity Assessment is a no cost evaluation of your medical management and population health operations. Our experienced leadership will thoroughly assess your programs and processes including auditing concepts, tools, software, vendor performance, organizational design and more.
Upon completion of the assessment, we will provide you with a list of targeted opportunities and estimated savings so that you can be assured of value and be confident in your selection of Clearlink Partners to optimize your Clinical Management strategy!