Best Utilization Management Software - Page 2
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Compare the Top Utilization Management Software as of August 2025 - Page 2
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Envolve MSO Healthcare
Envolve
Through valuable partnerships and experience, Envolve drives real healthcare transformation through value-based, affordable care solutions. Envolve MSO services provide organizations with the strategies, people, and processes necessary to provide value-based, affordable care and drive real healthcare transformation. As a leading healthcare management services provider, we bring innovation, experience, and resources to help drive performance in outcomes-focused and value-based reimbursement models. Our healthcare management services allow for better healthcare and efficiency in the delivery of care through best-in-class business administration services, data utilization, clinical excellence, and operational support. Envolve brings significant experience investing in innovative benefit designs for numerous products throughout the country for publicly funded, marketplace, and commercial programs that positively influence individuals' health and quality of life. -
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naviHealth
naviHealth
naviHealth is the future of senior-centered care through our partnerships with health plans and providers. Simplify and improve care transitions with technology. News, insights, and analysis from the experts improving the health care experience for seniors. naviHealth offers in-market clinical support with proprietary post-acute care planning tools to improve patient functional recoveries and reduce unnecessary medical costs. naviHealth enables our partners to effectively and efficiently manage care transitions through our unique patient care management. We pair in-market clinical support with proprietary technology to help guide the individual’s path to recover, increase patient satisfaction, reduce unnecessary post-acute care spending, and streamline processes. naviHealth employs in-market care coordinators who provide connected support between the patient, their family, and their healthcare providers. -
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Bamboo Health
Bamboo Health
With an innovative suite of solutions and the most interoperable care collaboration network, we are realizing a vision of whole-person care that’s shifting expectations and revolutionizing healthcare. Enabling more informed decision-making and better outcomes starts with a promise, a promise to continue listening, collaborating, and disrupting. It’s the heart of our vision and the reason we are able to drive powerful results across all settings of care. Decide on the right care options and act with certainty with real-time insight and the largest care collaboration network in the nation. Quickly identify the optimal path forward with lightweight solutions that streamline workflows and expedite patient care. Reduce risk, lower costs and accelerate the adoption of value-based care with access to proactive intelligence that until now has been unavailable. Make whole person care a reality with valuable context that includes both physical and behavioral health experiences. -
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SAC
SAC
We offer a range of comprehensive products and solutions, created by computer doctors who take the online systems data and tools offered to a higher level. Cost-effective system to optimize patient flow, improving productivity, performance, and patient experience. Invest more time in your patients and less on your computer. Reduce absenteeism, presenteeism, and disability in your business. Our system allows you to make a difference and improve the monitoring and promotion of your services effectively. Let us help you take care of your older adults. We offer you the necessary tools to improve the effectiveness and efficiency of your processes. We analyze and develop to suit your requirements. We are health computer professionals who understand and speak the health language. It is the platform that offers you less time administering and more caring for patients. Any advance in technology that serves to improve the life of a human being must be shared. -
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SSI Access Director
SSI Group
Making the front end your first priority. Integrated front-end solutions to improve patient financial experience and revenue cycle results. Determine address deliverability, minimizing returned mail and unpaid invoices. Reduce input errors by confirming patient identity and demographic information. Verify patient insurance eligibility at the point of service. Maximize revenue and regulatory compliance by verifying medical necessity before service. Automate PA end to end in just seconds. Automate the notification process to ensure timely notice of inpatient hospital admittance to payers. Promptly and accurately communicate patient out-of-pocket expenses. Increase collections by determining propensity to pay and financial aid eligibility. Once overlooked, patient access has become a driving force in hospitals. Our flexible platform provides a powerful synergy of integrated information from multiple verification sources combined with intelligent guidance. -
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Valenz Health
Valenz Health
Our single end-to-end platform of fully integrated health plan solutions delivers value and simplifies the complexity of healthcare for employers, members, providers, and payers. Valenz integrates member-centric services with data-driven insights, connecting the dots with personalized service and guidance for high-quality care and improved outcomes. We engage early and often with results-driven education, support, and services to avoid more serious and costly health events. With Valenz, you can have a healthier member population while also achieving plan and member cost savings, year after year. For the tools and transparency you need to make cost-effective, quality-first decisions, let’s find your path to smarter, better, faster healthcare today. With a suite of fully configurable solutions integrated into one ecosystem strategy, the Valenz healthcare ecosystem optimization platform offers extensive visualization of cost, quality, and utilization opportunities. -
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Collective Medical
Collective Medical
Collective curates patient data into a focused alert to help ED providers make rapid, informed decisions for better patient outcomes. Get notifications for patients with patterns of high utilization or complex needs as soon as they register—notifications are also sent to other members of the patient’s care team, so they can intervene and redirect patients to more appropriate settings for care to avoid misuse of emergency room services. Collective delivers notifications directly into your systems, regardless of EHR, or sends alerts by fax, network printer, email, or text message. This ability to embrace each facility’s unique needs and workflows aligns providers, giving them a shared playbook—wherever the patient goes, the collective follows. -
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EazyHMS
Zebricon Technologies
A complete hospital management system is an all-in-one solution for the hospital's all workstation, we are aiming for a paperless system and especially focusing on reducing management efforts to maintain all its work. Keeping in mind of technology trend we committed to allow access from all devices. Designed with the aim to minimize the efforts of the client and increase their productivity towards their work by serving them faster, easier, and correct outcomes. All you need to access the hospital software application is a browser and an internet connection. This is generally available on a wider range of devices and from anywhere in the world, making SaaS more accessible than traditional business software installation. -
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MemberMatch
Experian Health
Claims cycles can take months, and by then it is far too late to manage these costs. Even a delay of minutes in awareness of patient activity could result in an unnecessary, costly admission — thus when it comes to care coordination and success in value-based contracts. MemberMatch provides these insights in real time, providing care teams intelligence as early as possible so that they can rally around active episodes of care proactively and efficiently. This helps risk-bearing organizations optimize the quality and cost of member activity in the continuum of care, leading to better outcomes for patients and a better bottom line for organizations responsible for their health. Connect your care team with the attending clinical staff, providing key context to optimize the quality and cost of encounters, potentially avoiding unnecessary, out-of-network admissions and duplicate tests. -
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HCS Assessments & Documentation
Health Care Systems
A comprehensive and flexible toolset that enables clinicians to assess, review, document and follow up on patient status. The HCS Assessments Design Kit allows users to create and/or customize clinician-level documentation based on existing or prospective workflows. If your facility currently documents on paper or another EHR, the HCS Assessments Design Kit provides the flexibility to mimic your existing documents while capturing data discretely. The end user can select from a library of existing assessments, build custom assessments, or both. Assessments can be used as a one-time documentation event or as ongoing documentation with configurations that allow the facility to specify data entry as optional or required. Data entry can be accomplished via text input, drop-down select, radio button and multi-select options making customization simple and workflows effective. Below is an abbreviated list of available templates. -
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MyOutcomes FIT
MyOutcomes
FIT eLearning is a new, accelerated, way to learn and implement feedback-informed treatment. Based on the ground-breaking PCOMS evidence-based practice, FIT eLearning is designed to help you gain capabilities and confidence regardless of your learning style. Excellent understanding of PCOMS and FIT. A meaningful outcome and session rating process for clients. Adoption of a simple red, yellow, and green signaling system to keep sessions on track. An ability to map your clinical effectiveness across clients. Identification of your professional baseline. The ability to measure micro improvements in future skills growth. A certificate for 12 hours of online psychotherapy training in feedback-informed treatment. Whether you’re an individual practitioner or part of a larger organization, FIT eLearning helps you develop a culture of feedback and incorporates the outcome and session rating scales (ORS & SRS) into your clinical practice. -
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StrataJazz
Strata Decision Technology
The overall budgeting process for hospitals is badly broken. The typical organization spends three to six months and 100,000+ hours producing a budget that is usually tens of millions of dollars off the mark and out-of-date the moment it is finalized. There has to be a better way… and there is. StrataJazz is the deepest Advanced Planning tool on the market, radically simplifying and streamlining how healthcare providers plan, budget, forecast and manage their operating and capital expenses. The end result is a planning process that is more efficient, accurate, and agile. StrataJazz leverages top-down rolling planning approaches, seamless integration of relevant cost data, and best-practice automation, workflow, and analysis to deliver a collaborative, results-oriented budgeting process and plan that is significantly more accurate and radically less time-intensive. -
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Enable high-value decisions and elevate cross-functional collaboration across the care ecosystem. Incedo™ Healthcare Management Platform offers a comprehensive medical management solution that seamlessly integrates care management, utilization management, care coordination, and health care navigation interventions to improve operational efficiencies and health outcomes. Facilitate communication and collaboration between Care Management, Clinical and Utilization Management teams with a shared view of the member care plan and an easy transition between UM and CM Enhanced Data Capabilities Simplify data capture and CMS compliance using a flexible data repository that is customizable for granular data tracking and reporting simplify data capture and CMS compliance using a flexible data repository that is customizable for granular data tracking and reporting System Interoperability.
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iTraycer
Medical Tracking Solutions
Managing inventory is incredibly important to companies in many industries, but maybe more so in the medical device industry where a single product can cost thousands and surgical loaner kits cost tens of thousands. Effectively tracking, managing, and leveraging field inventory enables medical device manufacturers and hospitals to realize increased sales revenue, reduce capital investments in inventory, and lower operating expenses. Medical Tracking Solutions, Inc. (MTS) was established by an experienced team of industry professionals with expertise in the areas of medical device sales, distribution, logistics, loaner kit processing, and software development. Today, manufacturers and hospitals independently use the MTS proprietary software, iTraycer, or they take advantage of our complete service where MTS partners with logistics providers to offer a turnkey solution for case scheduling and medical device field inventory management.Starting Price: $50 per user per month -
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Personify Health
Personify Health
Personify Health is the first personalized health platform company, offering integrated solutions that combine health, wellbeing, and navigation services. Formed through the merger of Virgin Pulse and HealthComp in November 2023, Personify Health aims to simplify healthcare by providing personalized, connected, and user-friendly experiences. Their comprehensive platform includes services such as health plan administration, holistic wellbeing programs, and care navigation, all designed to empower individuals to engage more deeply with their health. By leveraging data-driven personalization and science-backed methodologies, Personify Health helps businesses optimize their healthcare investments while improving health outcomes for their members. -
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Care Management Suite
Health Catalyst
The Care Management Suite is a data-driven care management solution with tools and processes that deliver visibility across the continuum for high-risk and at-risk populations, facilitate more streamlined and patient-centric workflows, improve the quality of patient care, and reduce overall costs. With data analytics revealing opportunities for improvement throughout the process, the Care Management Suite improves clinical, operational, and financial outcomes. The Care Management Suite consists of three applications: Population Builder™: Stratification Module, Population Care Workflow, and Population Care Insights. An end-to-end, streamlined workflow for everything from patient enrollment, active care management, patient records, and care coordination between all care team members saves time and improves care. An analytics-driven DOS platform aggregates disparate claims and EMR data to provide a comprehensive patient view. -
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CircleLink Health
CircleLink Health
Our setup process is simple. We do the work to integrate our HIPAA compliant software and services into your existing workflow. The software helps stratify your patient population to identify patients who may qualify for CCM and other preventative programs. Our care team + software can manage enrollment/eligibility, patient call cycles, administrative record keeping and more. With our seamless integration, we have our fingers on the pulse of your patients’ needs. Our one-click interface gets physicians crucial information about patients who need immediate attention. Here’s how it works: -
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Trella Health Marketscape
Trella Health
There are patients who desperately need your home health services — yet many physicians who could be referring them aren’t. That’s likely because your sales and marketing teams aren’t seeing the 75% of Medicare claims associated with office visits. Demonstrate your ability to lower costs and improve patient outcomes. Home Health Agency A can quickly demonstrate how it outperforms Home Health Agency B on hospitalization and readmission rates. Marketscape for Home Health helps you redefine your sales and marketing strategy to ensure you’re focusing on high-potential physician and facility referral sources. Our breakthrough technology and support help you: Quickly evaluate how you compare to your peers by hospital and readmission rates, diagnostic category, acuity level, time to start of care, total cost of care, and many other quality metrics. -
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Carta Healthcare
Carta Healthcare
Our industry-leading, artificial intelligence (AI)–driven technology converts both structured and unstructured healthcare data into a high-quality, reliable, standardized dataset that can be used across your organization. Accessing data in near real-time from disparate systems, our products and services reduce the burden of manual data abstraction so your administrative and clinical teams can recapture that time for quality and research initiatives. Our products and services allow you to collect, analyze, and act on your data, regardless of data source, therapeutic area, organizational department, or existing reporting, BI, or analytics tools. Atlas uses human expertise and the power of AI to automate and simplify the resource-consuming task of finding and interpreting patient data for clinical registries. Cartographer searches, analyzes, and interprets patient data across all platforms, standardizes those data into a consistent format, and provides relevant data recommendations. -
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CareStat
SHP
CareStat is SHP’s comprehensive post-acute analytics solution that unites acute care providers, ACOs, payers, and physician groups with skilled nursing facilities (SNF) and home health agencies (HHA). Our goal is to jointly advance the management of patient outcomes, operations, utilization, and post-acute provider partnerships. In addition to SHP’s proprietary readmission algorithms, CareStat uses real-time OASIS (HHA) and MDS (SNF) data, to support patient management across the continuum of care. Reduce readmissions and lower length of stay. Enhance collaboration and partnership efforts. Improve referral patterns and patient satisfaction. Save time by simplifying data transfer of quality and outcome metrics. When it comes to managing trends in a numbers-driven industry, your organization knows the importance of actionable insights. Your initiatives require the proper tools and know-how to operate at peak efficiency. -
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CaseTrakker
CaseTrakker
CaseTrakker products provide a comprehensive care management solution designed to ensure that your team always has up-to-date information and the tools to manage their members efficiently. CaseTrakker's comprehensive care management software includes an extensive collection of tools to meet all of your health management software needs - from care management to utilization review and everything in between. Our products provide the tools necessary to streamline core business operations and increase efficiency without compromising care management outcomes. CaseTrakker portals provide custom branded secure browser-based access to CaseTrakker data. portals offer a tailored experience and collaboration between members, providers, clients, and care management staff from any device. -
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Deepbody Analytica
Deepbody Analytica
We aggregate and analyze data from socioeconomics, EHR, breath, blood, saliva, stool, urine, DNA, sweat, hair, and your vitals. Your health data has carried many answers. With current advances in artificial intelligence, machine learning, and high power computing we can cross-reference data from multiple sources providing your doctor with a comprehensive view of your health risk factors. We constantly retrain our models with anonymous health data connected to our databank via a secure channel. Large data samples are beneficial for the accuracy of data models. This increases the abilities of AI to discover health risks much sooner in comparison to traditional methods, potentially saving lives. Most doctors concentrate on detection, our machine-learning models are focused on prevention and risk assessments. -
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AxisCore
HealthAxis
Gain a competitive advantage with AxisCore™, leveraging state-of-the-art and modularized technology for seamless automation of your health plan administration. Say goodbye to the complexities of a cumbersome core administrative processing system (CAPS) and embrace our fully integrated solution. Meticulously crafted to optimize benefits administration, healthcare claims processing, and overall health plan management, AxisCore™ empowers your organization to thrive in today's dynamic healthcare landscape. -
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TeleTracking
TeleTracking Technologies
For three decades, health systems have relied on TeleTracking’s operational platform to manage bed capacity and track patient progression from various access points, through discharge, and into the post-acute care setting. TeleTracking creates system-wide situational awareness and operational foresight to reduce complexity and improve productivity. Our differentiated approach, coupled with our unparalleled patient flow expertise, ensures you reach your long-term organizational goals to focus on delivering the best care to patients. The bottom line is at its core, TeleTracking’s has always been focused on saving lives, giving more time back to caregivers and giving patients a positive experience—by helping ensure patients have access to the level of care they need where and when they need it. Furthermore, given the financial pressures that health systems face—especially now—TeleTracking helps improve care delivery without adding cost, space or inventory. -
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TAGNOS
TAGNOS
TAGNOS empowers healthcare workers to provide an elevated level of patient care. Perform more surgeries safely and efficiently by improving on-time starts, accelerating room turnover, increasing scheduling capacity, implementing real time situational awareness, and more. Treat and satisfy more patients with structure and accountability by decreasing left without being seen (LWBS) rates, accelerating time to treatment, streamlining intra- & inter-departmental communications, and more. Deliver improved asset utilization and reduce supply waste, eliminate search times, streamline work orders, optimize par levels, and more. TAGNOS OR Orchestration safely and efficiently empowers healthcare professionals to perform more surgeries by providing real time situational awareness and data-driven performance insights. OR Orchestration improves on-time starts by accelerating room turnover and optimizing schedule utilization for a better patient experience. -
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HolCare EHR+
Holmusk
HolCare EHR+ is a cloud-based, state-of-the-art electronic health record platform designed to meet the needs of mental health agencies, telepsychiatry groups, research organizations, and other disruptive care models. MBC has been proven to improve care, increase response to treatment, help clinicians make better decisions, and contribute to better outcomes. However, when not integrated directly into an EHR, MBC is challenging to implement and can diminish productivity. HolCare EHR+ solves for this problem with fully integrated MBC, providing an easy way to collect measures that are meaningful to patient care. HL7 FHIR native support enables the use of any third-party health care technology. This standard eliminates the need for expensive, time-consuming “custom integrations” in favor of a platform that can share both clinical and non-clinical data with partners. -
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AssureCare MedCompass
AssureCare
AssureCare is a privately held healthcare technology company that provides innovative care management solutions to commercial and health and human service providers. AssureCare’s flagship software platform, MedCompass, is used by healthcare providers throughout the United States to deliver end-to-end care management for millions of patients daily. MedCompass transforms healthcare management by automating processes and streamlining workflows, thus allowing care professionals to make better decisions that dramatically improve the quality of care and lower costs. AssureCare is considered an industry leader in developing, modular, seamless solutions designed to improve patient outcomes and reduce avoidable costs associated with population health management.