Case Studies
Charting a New Course for D-SNP Compliance
One regional health plan struggled to meet CMS expectations for its Dual-Eligible Special Needs Plans (D-SNP) case management program, risking sanctions due to documentation issues, staffing gaps, and audit vulnerabilities. See how they partnered with Clearlink to remediate operations, deploy a co-sourced team, and pass their CMS audit with confidence, all while laying the groundwork for long-term program success.
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Case Studies
Improving BH Strategy Through Rapid Assessment
A large, state-based health plan faced an urgent need to strengthen its behavioral health strategy to compete for a new line of business. With limited time and integration challenges ahead, it turned to Clearlink for a rapid yet comprehensive evaluation. See how our team delivered a high-impact assessment that uncovered gaps, set a clear roadmap, and helped the health plan win the bid, fully prepared to meet new regulatory expectations and elevate outcomes.
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Case Studies
Navigating MLTSS Implementation for Market Entry
One managed care organization set out to launch a Medicaid Managed Long Term Services and Supports (MMLTSS) program but lacked internal experience with its requirements. See how they partnered with Clearlink Partners to develop a compliant, scalable strategy from the ground up, gain operational clarity, and move confidently toward program readiness and implementation success.
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Blogs
How Small to Mid-Size Health Plans Benefit from Outsourcing & Consulting
Whether it’s support during a regulatory audit, help scaling operations to accommodate new membership, or guidance on improving clinical workflows, outside experts can deliver high-impact results without adding permanent overhead. Learn more about the tangible benefits of investing in strategic support through health plan consulting and health insurance outsourcing.
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Blogs
How AI is Transforming Prior Authorization: Real-World Examples & Future Implications
As healthcare organizations continue to seek solutions that reduce costs and improve patient outcomes, AI-driven prior authorization is proving to be a game-changer. Explore how AI is transforming the prior authorization process and discover real-world examples of how it’s being implemented across the healthcare landscape.
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Blogs
Denials Management Best Practices for Cutting Costs & Improving Care
Denials aren’t going away, but the way they’re handled makes all the difference. Many health plans are still using outdated processes for denial management in medical billing that slow down approvals and create unnecessary friction. Learn how to take a more proactive path to minimize disagreements, reduce costs, and improve healthcare delivery.
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