Care Management Solution for Health Plans

Your one-stop shop for a comprehensive set of practical, AI-powered solutions to today’s—and tomorrow’s—challenges. Empower your teams to accurately administer benefits, manage the organization, and profitably run the business for the best outcomes for everyone.

Apply analytics to transactions to indicate potential care gaps or identify member populations/providers who should receive specific updates—all while supplying enriched data feeds to other payers and facilitating greater continuity.

A powerful, FHIR-based interoperability gateway that facilitates payer compliance with the Patient Access API, Provider Directory API, Payer-to-Payer Data Exchange requirements of the Final Rule, and more.

This groundbreaking platform aggregates data from a wide variety of government, claims, and assessment sources to provide accurate indications of social risk at a community and personal level.

A forward-thinking performance monitoring and analytical solution with an embedded omnichannel workflow that centralizes HEDIS and CMS Stars quality program data, improves care gap closure rates, and empowers value-based care reporting.

Your solution for hierarchical condition categories (HCCs) visualization and analysis. The RA Navigator brings risk adjustment data into the complete member profile, empowering care managers to act.

Whether you are pursuing broad-based population health initiatives, focusing on a handful of specific disease states, or refining your approach to utilization management, the care management capabilities in Jiva drive workflow efficiency, quality, and cost savings.