Care
Management
Enable care managers with intelligent AI insights and seamless automation to optimize patient support and streamline workflows.
The Challenge
Care teams are overwhelmed and underequipped.
Strained resources
Scalability issues that limit focus to only the highest-risk members
Missed opportunities
Generic engagement that fails to connect with diverse needs.
Delayed care
Fragmented systems that stall coordination and decision-making.
Our Solution
From reactive to orchestrated with our care management solution.
Designed to streamline care management and drive personalized, actionable health insights. With real-time collaboration and goal tracking, you can improve outcomes and deliver patient-centered care efficiently.
Engage individuals across all risk profiles—from low, to rising, to high-risk—through personalized, real-time, guided health journeys that adapt to their unique needs.
Reduce pharmacy spend and minimize high-touch processes.
Proactively close care gaps with streamlined solutions that ensure every patient gets the attention they need, when they need it.
Drive higher HRA completion rates and accelerate risk identification & care program enrollment through digital HRA.
Agentic AI
Our AI agents accelerate care management.
Care Plan Recommendation Agent
Suggests evidence-based plans of care tailored to patient needs.
Prior Auth Review Agent
Accelerate medical review cycles and reduce administrative costs through intelligent automation.
Document Review Agent
Reduce processing time and rework by automating document validation and completeness checks.
Gap Closure Agent
Improve quality scores and incentive performance through proactive, data-driven gap identification.
Risk Adjustment Coding Agent
Improve quality scores and incentive performance through proactive, data-driven gap identification.
Data Platform
Our Unified Data Platform is the foundation of our solutions
Unified
data
Harmonize fragmented data into a platform built for healthcare to ensure seamless integration and effortless data management.
Actionable
intelligence
Trigger both human and automated interventions at the right moments to improve quality, reduce administrative burden, and lower medical costs for over 43 million lives.
Event-driven
workflow
Deliver personalized, context-rich workflows by transforming data into real-time insights and eliminating unnecessary administrative tasks through automation.
Case Studies
See how we’ve helped others with care management.
HarmonyCare Health Plan
“From day one, Medecision treated us like partners, not just clients. Their implementation team made onboarding smooth and surprisingly fast, and their support team continues to feel like an extension of our own staff.”
Hawaii Medical Service Association
“I’ve enjoyed working with the Medecision team since 2003. They’re very professional, knowledgeable and energetic. They inspire me to go the extra mile, to work harder. We started years ago with utilization management workflow, administration and reporting. By listening to customer feedback, Medecision has a positive impact on healthcare. Its solutions and services continue to help us achieve our vision of building a healthier, happier Hawaii.”
Health Home Partners of Western NY
“We were able to leverage the technology to help us find our patients, evaluate acuity, prioritize and coordinate actions, even when all other services were down.”
Brand New Day
“We’re always looking for ways to make our technology do more, and Medecision is a big help. We were able to configure our system to process authorizations much more easily for all of our Medicare Advantage members. Our physicians flock to Medecision once they learn their members’ risk scores – including pharmacy and lab data – are there and that they can automate their own authorizations. We all like the idea of having everything coordinated in one system. That’s Medecision.”