Health plans are dealing with a constantly changing healthcare ecosystem—new technologies, regulations, measures and markets. In order to keep up, organizations must address the gaps and limitations in their core systems and processes.
We partner with organizations to assess and thoughtfully modernize their critical application assets to ensure they…
• Meet current and future demand
• Are secure, scalable, and cost-effective to operate
Clearlink’s Claims Operations & Systems experts empower managed care organizations through exercising their decades of industry experience and knowledge of best practices, methodologies, tools, and technologies. Clearlink’s vision is to optimize claims operations for our clients to ensure the availability of accurate and critical information, advance strategic decision making, and achieve business goals.
Identifying the right customized solution to ensure a speedy and smooth implementation, stabilization, or optimization, whether your organization is replacing an outdated legacy application and you need assistance in selecting and implementing a new system, or you are upgrading your current system.
Ensuring business rules are encoded, tested, and optimized to improve transaction timeliness and accuracy, leading to significant operational savings.
Reviewing current business process models, identifying improvement and automation opportunities, and designing workflows aligned to an organization’s unique culture and allowing an organization to work smarter, not harder.
Evaluating and optimizing an organization’s underlying data management for a given functional domain focused on data accuracy, quality, maintenance, availability, and timeliness.
Analyzing current operational states and defining and documenting opportunities on which future successes can be built, uncovering costsavings opportunities and addressing any gaps in claims, configuration, and/or quality processes.
Clearlink’s Opportunity Assessment is a two-day, no-cost evaluation of your core systems’ operations. Our experienced leadership will thoroughly assess your programs and processes including Configuration requirements against design and build, Claims Operational Standard Operating Processes, Pre and Post Implementation of new software or new plan design, Quality Review Programs, Production Support team processes 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 Core Systems strategy!