List of the Top Utilization Management Software for Freelancers in 2025 - Page 2

Specialty and rare diseases frequently involve patient groups that are ambiguously defined, including those who are undiagnosed or improperly diagnosed, as well as healthcare professionals who might be uninformed about these disorders and their diverse presentations, leading to treatment pathways that lack clarity. IPM.ai functions as an Insights-as-a-Service (IaaS) organization, committed to equipping prominent life sciences companies with profound insights into patient care, thereby improving the quality of life for affected individuals via the advancement, clinical investigation, and marketing of therapeutic options. By forecasting market dimensions, scrutinizing the competitive environment, and assessing potential returns on investment, businesses can refine their commercialization tactics effectively. In addition, the platform plays a crucial role in recognizing undiagnosed or misdiagnosed patients who could gain from early intervention and therapeutic solutions. It utilizes statistical methodologies to evaluate the occurrence of particular diseases among specific patient demographics at any time. Moreover, IPM.ai aids in identifying physicians who excel in diagnosing and treating these optimal patients, while also motivating other healthcare practitioners to improve overall patient outcomes. This all-encompassing strategy ultimately seeks to close the gap in understanding and addressing the requirements of individuals with rare diseases, ensuring they receive the attention and care they deserve. By fostering collaboration among healthcare providers, IPM.ai aims to create a more informed and responsive healthcare ecosystem.

The SMAF tools have been integrated into a unified, shareable information system that allows for the automated calculation of SMAF profiles. This innovative system generates reports that assist in evaluating outcomes and formulating care plans, making it user-friendly for healthcare practitioners. Moreover, it fosters improved networking and organization of services while eliminating the need for software installation. The iSMAF, which is the fifth major iteration of our software, functions as web-based technology that modernizes traditional clinical tools and processes associated with the SMAF tool. Tailored specifically for the province of Quebec, the iSMAF version includes key features such as the PRISMA-7, the SMAF assessment grid, the social-SMAF, an Iso-SMAF profile generator, and a care planning table. In addition, it offers a range of capabilities that enable clinicians and administrators to generate reports focused on particular topics or demographics, thus promoting an in-depth understanding of the facility, tracking profile changes over time, or conducting comparisons among different groups based on their respective profiles. This comprehensive integration signifies a substantial leap forward in enhancing the efficiency of health assessment management and care planning, ultimately improving patient outcomes.

We work alongside government agencies and humanitarian organizations to develop health information systems that are centered on human needs and are open-source. By leveraging vital insights, we empower health workers, policymakers, and patients across Africa. Our specialization is in digital health information systems designed for low-resource environments throughout the continent. We focus on both software and hardware solutions for healthcare facilities. Our comprehensive approach includes everything from the initial design and development phases to implementation, training, and continuous support. As we look to the future, we plan to integrate data analysis to improve the management of limited resources. We are convinced that robust health systems, combined with the dissemination of essential information, can greatly improve health outcomes on a global scale. Our strategy emphasizes strengthening local health infrastructure by involving communities to tackle their unique challenges. We are committed to investing in and developing systems that are accessible to low-income countries, which in turn supports their ability to create self-sustaining solutions. As a non-profit organization based in Africa, we strive to advance global health through the creation of information systems, building partnerships, and enhancing local capacities, with the ultimate goal of achieving a healthier future for everyone. By fostering regional expertise, we ensure that the solutions we provide are not only effective but also sustainable over the long term, thereby leaving a lasting impact on health systems in these communities. This collaborative effort is essential for promoting resilience and adaptability in the face of evolving health challenges.

Lightbeam is dedicated to enhancing population health by transforming data insights into actionable results, effectively addressing care gaps and minimizing risks. This method not only improves the standard of care but also elevates the overall well-being of patients. Through its comprehensive population health management platform, Lightbeam synthesizes diverse data sources to deliver a holistic 360-degree perspective on patients, which is vital for optimizing value-based care outcomes. In today's value-based care environment, effective risk management relies heavily on insights derived from data. Lightbeam's cutting-edge platform uniquely organizes patient data, facilitating the timely and strategic use of pertinent information. The influence of Lightbeam goes beyond merely changing how clients approach value-based care; it has played a crucial role in realizing substantial financial savings, accumulating over 2 billion dollars for clients since its launch in 2014, and its impact is just starting to unfold. Additionally, the technology-enabled services provided by Lightbeam seamlessly enhance these efforts, offering further resources to improve client outcomes. Consequently, organizations that collaborate with Lightbeam are well-positioned to make significant strides in their population health initiatives and achieve sustained success. The partnership with Lightbeam not only fosters growth but also ensures an ongoing commitment to innovation in healthcare management.

We improve the operational efficiency of various healthcare facilities worldwide while also enhancing the experiences of patients and staff alike. Our innovative solution simplifies ambulatory care pathways, granting patients increased reassurance. With LGI eClinibase, the clarity of patient care pathways is notably enhanced, and waiting periods are minimized through the distribution of comprehensive information about each care event. The shift from paper to digital formats enables swift access to essential data concerning referrals, waiting lists, and appointments. Users benefit from the ability to create lists and summaries from various clinical administrative systems related to all care episodes. The platform ensures seamless management of referrals, appointments, and patient communications throughout the entire facility, fostering an integrated workflow. In addition, it provides automatic recommendations for correcting patient records and efficiently detects duplicate entries. Beyond that, it manages the agenda of professional activities, which includes intake management, appointments, clinical documentation, and statistical reporting for the MSSS, thus significantly enhancing operational efficiency across the healthcare sector. Our commitment to technological advancement in healthcare continues to shape a more effective and patient-centered environment.

Empower your healthcare personnel with sophisticated clinical-decision support software that eliminates uncertainty in capacity management throughout the entire hospital setting. This evidence-based tool not only improves bed turnover rates but also enhances the overall patient experience. By leveraging predictive analytics and more accurate data, your team can markedly boost care coordination and increase patient satisfaction levels. The bed management system provides care teams with a comprehensive view of each patient's journey, enabling effective management of bed demand and capacity across single or multiple healthcare facilities. Equip your physicians, nurses, and clinicians with software that reduces clinical biases and standardizes data collection processes. Medworxx goes beyond providing predictive analytics by utilizing data to anticipate trends, offering healthcare professionals more valuable insights. In addition, this technology cultivates a more streamlined and informed approach to patient care, which is crucial for improving the operational efficiency of hospitals. Ultimately, by embracing such innovative solutions, healthcare facilities can significantly elevate both the quality of care and patient outcomes.

Envolve is dedicated to revolutionizing the healthcare landscape by utilizing strategic collaborations and a wealth of experience to provide cost-effective, value-based care solutions. The offerings from Envolve MSO empower organizations with vital strategies, proficient personnel, and efficient processes that focus on delivering affordable healthcare and driving authentic change in the industry. As a leading provider of healthcare management services, we incorporate innovation and professional knowledge to improve performance within frameworks that prioritize outcomes and value-based reimbursement. Our all-encompassing healthcare management services enhance both the quality and efficiency of care delivery, underpinned by superior business administration, effective data utilization, clinical excellence, and strong operational support. By focusing on groundbreaking benefit designs across various products nationwide, Envolve plays a significant role in supporting publicly funded, marketplace, and commercial programs, which in turn improves individuals' health and overall quality of life. This unwavering dedication to innovation and enhancement not only strengthens our position in the industry but also plays a critical role in shaping a healthier future for everyone. Ultimately, our vision is to ensure that every individual has access to the high-quality healthcare they deserve.

naviHealth is transforming the landscape of senior care by partnering with health plans and providers to streamline the care transition process using advanced technology. Our primary goal is to simplify these transitions while enhancing the overall experience for seniors, providing essential news, insights, and expert evaluations. Through our unique tools designed for post-acute care planning, naviHealth offers clinical support that not only aids in patient recovery but also reduces preventable healthcare costs. By leveraging our specialized patient care management system, we empower partners to oversee care transitions more efficiently. The integration of in-market clinical assistance with state-of-the-art technology ensures a more seamless recovery path for patients, boosts satisfaction rates, and cuts down on unnecessary expenses related to post-acute care. Additionally, the committed care coordinators at naviHealth play an essential role in fostering clear communication among patients, their families, and healthcare professionals, ensuring that everyone stays informed throughout the recovery journey. This cohesive support network ultimately fosters improved health outcomes and a more streamlined care experience, reinforcing the importance of collaboration in healthcare. In this way, naviHealth exemplifies how innovative strategies can create a positive impact on senior-centered care.

We offer a comprehensive range of innovative products and solutions crafted by industry experts who take online systems, data, and tools to new heights. Our cost-effective system is specifically designed to streamline patient flow, which in turn enhances productivity, overall performance, and the experience of patients. By utilizing our services, you can devote more attention to your patients rather than getting bogged down by administrative tasks. Our solution significantly mitigates issues related to absenteeism, presenteeism, and disabilities within your organization, resulting in a more efficient workforce. With our platform, you can make a profound difference by improving the oversight and promotion of your services. We are dedicated to supporting you in providing care for the elderly demographic, ensuring they receive the attention they deserve. The tools we offer are indispensable in boosting both the effectiveness and efficiency of your operations. Our team performs comprehensive analyses to create customized solutions tailored to your unique requirements. As specialists in healthcare technology, we understand and speak the language of the industry fluently. Our platform drastically reduces the burden of administrative tasks, enabling you to invest more time in direct patient care. We are firm believers that any technological progress that aids human welfare should be shared for the benefit of all. By collaborating, we can pave the way for a healthier future for all individuals in our communities, fostering a spirit of collective well-being and care.

Focusing on the front end is vital for improving the patient financial journey and streamlining revenue cycle results. By adopting unified front-end strategies, healthcare organizations can tackle delivery challenges, which in turn decreases the number of returned mail and outstanding invoices. It's important to limit input mistakes by thoroughly verifying patient identities and demographic information. In addition, checking insurance eligibility at the service point is crucial for maximizing revenue while adhering to legal requirements. Streamlining processes through the automation of prior authorization from beginning to end within seconds can enhance overall efficiency. Moreover, automating notifications ensures that payers receive prompt updates about inpatient hospital admissions. Providing clear communication regarding patients' out-of-pocket costs further enhances financial transparency. By evaluating patients' willingness to pay and their eligibility for financial assistance, hospitals can significantly improve their collection rates. Once considered a secondary priority, patient access has now emerged as a key factor in healthcare settings. Our flexible platform leverages integrated data from multiple verification sources, accompanied by smart guidance, to develop a holistic solution. This integration not only enhances patient access but also propels the overall effectiveness of the organization, ultimately leading to better financial outcomes and patient satisfaction.

Our all-encompassing platform delivers fully cohesive health plan solutions that simplify healthcare for employers, members, providers, and payers, while simultaneously adding substantial value. Valenz merges member-centric services with data-driven insights, fostering connections through personalized assistance that results in superior care and improved health outcomes. We emphasize proactive and regular engagement through impactful education and support services aimed at thwarting more serious and expensive health issues in the future. By opting for Valenz, you can cultivate a healthier member base while continually realizing cost savings for both plans and individual members year after year. To tap into the transparency and resources needed for making informed, quality-focused, and cost-effective choices, let’s explore your route to a more streamlined healthcare experience today. Moreover, the Valenz healthcare ecosystem optimization platform includes a comprehensive array of fully customizable solutions, all integrated within a unified strategic framework, providing a detailed visualization of cost, quality, and utilization opportunities, ensuring you are well-prepared to adeptly navigate the complexities of the healthcare environment. This holistic approach not only enhances efficiency but also empowers stakeholders to make more informed decisions, ultimately leading to better health outcomes for all involved.

Collective compiles patient data into an efficient alert system that empowers emergency department staff to quickly make informed choices, ultimately improving patient outcomes. Alerts are sent out immediately as patients register, targeting those who show excessive use of services or complex needs, and these notifications are also shared with the entire care team to facilitate prompt interventions and steer patients toward more appropriate care alternatives, reducing unnecessary emergency service utilization. The system's notifications are designed to integrate smoothly across various platforms, irrespective of the electronic health record system in place, or can be transmitted through other means such as fax, network printers, emails, or text messages. This flexibility in adapting to the specific needs and workflows of different facilities enhances provider collaboration, providing a cohesive strategy that ensures continuous support for patients throughout their healthcare experience. By optimizing communication channels, this method not only elevates patient care but also leads to a more judicious allocation of healthcare resources, ultimately benefiting the entire healthcare system. The focus on streamlined communication and timely interventions fosters a proactive approach to patient management that can significantly reduce the strain on emergency services.

An all-encompassing hospital management system functions as a holistic solution for managing various operational activities within a healthcare establishment, focusing on fostering a paperless atmosphere while optimizing management workflows. By embracing modern technological advancements, we provide users with the ability to access the system from virtually any device, which significantly boosts overall productivity. The design of the system aims to alleviate the burden on users, allowing them to execute their responsibilities more efficiently and obtain quicker, more precise outcomes. To access the hospital software application, users only require a web browser and an internet connection, making it available across numerous devices and locations globally. This model presents a far more user-friendly alternative to conventional software installations, thereby enhancing the operational efficiency of healthcare organizations. Moreover, our dedication to continuous innovation ensures that we are well-equipped to address the dynamic demands of the healthcare landscape as it evolves. In this way, we strive to not only meet but also anticipate the future needs of our clients.

The process of claims can extend over several months, which complicates the management of related expenses as time progresses. A slight delay of just a few minutes in identifying patient activities can trigger an unnecessary and costly admission to the hospital, a factor that is vital for effective care coordination and the success of value-based contracts. MemberMatch offers these essential insights in real time, providing care teams with the timely information they need to proactively and efficiently manage ongoing care episodes. This strategy aids organizations that bear risk in improving the quality of care while also considering the financial impact of each member interaction throughout the continuum of care, leading to better patient outcomes and enhanced financial health for the entities responsible for their care. By fostering communication between your care team and the involved clinical staff, valuable context is delivered to enhance both the quality and cost-effectiveness of care encounters, which in turn helps to avoid unnecessary admissions to out-of-network facilities and duplicate testing. Ultimately, this timely data equips healthcare providers with the knowledge necessary for making decisions that can greatly benefit both the patients and the organizations they serve, ultimately fostering a more efficient and patient-centered healthcare system.

A comprehensive and versatile toolkit that enables healthcare providers to assess, review, document, and track patient conditions is crucial for delivering quality patient care. The HCS Assessments Design Kit allows users to tailor clinician-level documentation to align with existing or upcoming workflows. For healthcare settings that continue to utilize paper records or different electronic health systems, this kit offers the flexibility to replicate current documentation while ensuring accurate and confidential data collection. Users have access to an extensive library of pre-built assessments, the option to create their own, or the ability to combine both approaches. These assessments can be used either as a one-time documentation instance or for ongoing documentation, with facilities having the discretion to decide if data entry is required or optional. Multiple data entry methods—such as text fields, drop-down menus, radio buttons, and multi-select options—make customization easy and improve workflow productivity. Furthermore, a concise summary of the available templates is included below, providing users with a clear understanding of their options. This holistic approach not only streamlines documentation but also enhances the overall management of patient care processes.

FIT eLearning presents a contemporary and expedited approach for individuals seeking to master the application of feedback-informed treatment, grounded in the cutting-edge PCOMS evidence-based framework. This program is designed to boost your confidence and skills, accommodating a range of learning styles while ensuring a thorough understanding of both PCOMS and FIT methods. It promotes a meaningful evaluation process for clients, allowing for efficient tracking of session ratings through a simple red, yellow, and green signaling system. Moreover, participants have the ability to evaluate their clinical effectiveness across various client demographics, set a professional baseline, and observe steady improvements in their competencies over time. Upon successful completion, learners are awarded a certificate that acknowledges 12 hours of online psychotherapy training centered on feedback-informed treatment. Whether you work independently or are part of a larger healthcare team, FIT eLearning cultivates a robust feedback culture and adeptly incorporates outcome and session rating scales (ORS & SRS) into your therapeutic approach, which ultimately improves client care and engagement. By adopting this forward-thinking training, you will gain the essential tools to foster a more adaptive and impactful therapeutic setting, thereby enhancing the overall experience for both practitioners and clients alike.

The budgeting procedures in hospitals are inherently inefficient and flawed. Typically, these institutions dedicate between three to six months and more than 100,000 hours to develop a budget that frequently miscalculates by millions of dollars and becomes irrelevant almost immediately after finalization. A more effective alternative is necessary, and such an option is indeed available. StrataJazz emerges as the most thorough Advanced Planning tool on the market, revolutionizing how healthcare providers engage in planning, budgeting, forecasting, and managing both operating and capital expenditures. Consequently, the entire planning process is not only streamlined but also becomes significantly more accurate and adaptable to changes. By adopting top-down rolling planning techniques, smoothly integrating pertinent cost data, and leveraging advanced automation alongside best practices in workflow and analysis, StrataJazz cultivates a collaborative and results-oriented budgeting procedure that is remarkably precise and much less time-intensive. This groundbreaking method ultimately enables healthcare organizations to allocate their resources more effectively, thereby improving their overall financial performance and ensuring they can respond promptly to the dynamic nature of the healthcare landscape. Such advancements in budgeting practices are vital for the sustainability and improvement of healthcare services.

Enhancing strategic decision-making and encouraging better collaboration across various sectors of the healthcare ecosystem is essential. The Incedo™ Healthcare Management Platform offers a comprehensive solution for medical management by integrating care management, utilization management, care coordination, and healthcare navigation, all aimed at improving operational efficiency and patient outcomes. This platform fosters enhanced communication and teamwork among Care Management, Clinical, and Utilization Management teams by delivering a consolidated view of the member care plan, which ensures a seamless transition between different management areas. Its sophisticated data capabilities simplify data collection and maintain compliance with CMS regulations through a flexible data repository designed for meticulous data tracking and reporting. Moreover, it facilitates interoperability within systems, thereby promoting better integration across healthcare services. By adopting this cutting-edge platform, healthcare organizations can not only refine their operational workflows but also elevate the quality of care provided to patients. Ultimately, this innovation represents a significant advancement in the pursuit of effective healthcare management.

Effective inventory management is crucial across numerous industries, but it holds particular importance in the medical device field, where single items can cost thousands and surgical loaner kits may total tens of thousands. By proficiently tracking and managing inventory in the field, both medical device manufacturers and healthcare facilities can increase their sales revenue, decrease the amount of capital tied up in inventory, and lower operational costs. Founded by a talented team of industry professionals with expertise in medical device sales, distribution, logistics, loaner kit processing, and software innovation, Medical Tracking Solutions, Inc. (MTS) aims to address these challenges. Their proprietary software, iTraycer, is available for use by both manufacturers and hospitals, allowing for independent operation or the option of a full-service partnership where MTS works alongside logistics providers for comprehensive case scheduling and management of medical device inventory in the field. This flexible dual-service model effectively meets the varied demands of the medical device sector, ensuring that clients receive tailored solutions that enhance their operational efficiency. By leveraging the capabilities of MTS, stakeholders can adapt to the fast-paced changes within the industry while maintaining a competitive edge.

Personify Health emerges as an innovative platform dedicated to personalized health, providing a range of integrated solutions that address health, wellness, and navigation services. Formed from the union of Virgin Pulse and HealthComp in November 2023, this company aims to improve healthcare experiences by delivering services that are tailored, interconnected, and centered around the user. The platform encompasses a variety of offerings, such as health plan management, extensive wellbeing programs, and care navigation support, all designed to empower individuals to engage more proactively in their health journeys. Utilizing data-driven personalization and evidence-based methods, Personify Health assists organizations in optimizing their healthcare investments while simultaneously improving health outcomes for their members. By prioritizing the unique needs and preferences of individuals, Personify Health is not only setting a new benchmark in healthcare but also inspiring a shift towards more individualized care. This commitment to personalization demonstrates the company’s dedication to revolutionizing how health services are perceived and utilized.

The Care Management Suite serves as an all-encompassing, data-driven solution for overseeing care, equipped with a variety of tools and methodologies that aim to improve transparency across both high-risk and at-risk patient demographics. Its design promotes more effective and patient-centered workflows, ultimately striving to boost the quality of care while reducing overall healthcare expenditures. Utilizing data analytics, the suite pinpoints opportunities for enhancement within the care continuum, resulting in improved clinical, operational, and financial outcomes. Comprising three essential applications—Population Builder™: Stratification Module, Population Care Workflow, and Population Care Insights—each component plays a crucial role in the management of care. The suite delivers a unified, comprehensive workflow that integrates processes from patient enrollment and continuous care management to maintaining patient records and fostering collaboration among healthcare teams, ultimately saving valuable time and elevating care standards. Moreover, its analytics-centric Data Operating System aggregates diverse claims and electronic medical record data to provide a complete view of each patient’s health status. By harnessing these insights, healthcare professionals can make better-informed decisions that are geared towards enhancing patient outcomes, which is essential in today’s evolving healthcare landscape. In essence, this innovative suite not only streamlines care management but also empowers providers to deliver superior healthcare services effectively.

Our setup process is designed to be both simple and highly efficient. We proactively integrate our HIPAA-compliant software and services into your existing workflows without disruptions. This innovative software is tailored to assess your patient demographics, identifying those who may qualify for Chronic Care Management (CCM) and other preventive health initiatives. By combining our committed care team with cutting-edge technology, we streamline various administrative tasks such as enrollment, eligibility checks, patient outreach, and detailed record-keeping. Our holistic approach ensures that we remain responsive to your patients' needs, facilitating prompt action when required. Furthermore, our intuitive one-click interface equips healthcare providers with vital insights about patients needing immediate care, enhancing the overall efficiency of the system. Ultimately, our operation is structured to support better patient outcomes while easing the administrative burden on medical practices.

Many patients urgently require your home health services, yet a significant number of doctors who could make referrals are not doing so. This issue can likely be traced back to your sales and marketing teams' failure to utilize the 75% of Medicare claims associated with office visits. Demonstrating your ability to cut costs while improving patient outcomes is crucial. For example, Home Health Agency A can quickly prove its effectiveness compared to Home Health Agency B in terms of hospitalization and readmission rates. With Marketscape for Home Health, you can revamp your sales and marketing strategies to effectively engage the most promising physician and facility referral sources. Our cutting-edge technology and committed support allow you to evaluate how you stack up against your competitors based on various metrics, such as hospitalization and readmission rates, diagnostic categories, acuity levels, time to care initiation, overall care expenditures, and many other quality measures. Utilizing this data enables you to strategically direct your efforts towards increasing referrals, which in turn enhances patient care and elevates the overall reputation of your services. By embracing this approach, you not only meet the immediate needs of patients but also position your agency for long-term success in a competitive market.

Our cutting-edge technology, driven by artificial intelligence (AI), reshapes both structured and unstructured healthcare data into a reliable, high-quality, and standardized dataset suitable for application across your organization. By providing near real-time access to information from diverse systems, our solutions reduce the burden of manual data abstraction, allowing your administrative and clinical teams to regain precious time that can be redirected toward quality enhancements and research initiatives. Our comprehensive array of products and services equips you to collect, analyze, and leverage your data efficiently, regardless of its origin, therapeutic focus, departmental context, or existing reporting, business intelligence, or analytical frameworks. Atlas harnesses the combined strengths of human expertise and AI to simplify the complex task of discovering and interpreting patient data for clinical registries. In parallel, Cartographer adeptly navigates, assesses, and interprets patient information across various platforms, standardizing it into a cohesive format while delivering valuable insights. Ultimately, our groundbreaking solutions not only boost operational efficiency but also facilitate informed decision-making at every level of your organization, fostering a culture of continuous improvement and innovation. By integrating these advanced tools, you position your organization at the forefront of healthcare data management and strategic development.

CareStat serves as SHP's comprehensive analytics platform tailored for post-acute care, seamlessly linking acute care providers, ACOs, payers, and physician groups with skilled nursing facilities and home health agencies. Our objective is to collectively improve the management of patient outcomes, operational efficiency, resource utilization, and partnerships among post-acute care providers. By employing SHP's proprietary readmission algorithms, CareStat synthesizes real-time OASIS and MDS data, ensuring effective patient management across the full continuum of care. This approach is aimed not only at reducing readmission rates and decreasing hospital stays but also at enhancing collaboration and refining referral practices, which ultimately translates to improved patient satisfaction. Additionally, by optimizing the data transfer process for quality and outcome metrics, we enable organizations to conserve precious time. In today's metrics-driven environment, your organization recognizes the importance of actionable insights, and meeting your objectives requires the appropriate tools and expertise for optimal performance. Ultimately, CareStat is engineered to equip providers with the essential insights necessary to achieve superior patient care outcomes, fostering an environment where both patients and providers can thrive together.