Process Improvement Services

A group of healthcare professionals in scrubs engaged in conversation with each other in a clinical setting

MANAGED SERVICES

Embrace AI-enabled healthcare operations

We help healthcare clients gain a competitive advantage by combining clinical, business and process expertise with intelligent digital platforms to create efficient and agile healthcare operations.

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<h3>Modern AI-integrated healthcare operations</h3> <p>The playbook for growth is being rewritten. We believe the future belongs to the modern enterprise that embraces AI-integrated business operations—a business that can anticipate and act instantly to boldly seize opportunities amid rapid change.</p> <p>Innovative partnerships are essential for payers, providers and pharmacy benefits managers to succeed in the competitive healthcare field. We help clients rethink how they create value, innovate and grow by combining business and process expertise in the medical field with intelligent digital platforms to optimize business operations.<br> </p>

SHOWCASE

<h3><span class="text-accent2-dark">MetroHealth and Cognizant partnership in healthcare</span></h3> <p>MetroHealth’s partnership with Cognizant improved productivity by 8% and increased collection by 25%. Using the TriZetto® Advanced Reimbursement Manager (ARM) tool, denial rates dropped 30%, adding $13M in revenue. The collaboration continues to reduce receivables and improve outcomes through automation, innovation and shared expertise.</p>

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Overview

<h3>Business outcomes and strong ROI </h3>

$900M

cost savings over 7 years

17,000

hours of increased efficiency

75%

faster investigation response

25%

lower plan administration costs

600%

faster claims processing

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Outcomes

<h3>Healthcare process improvement services</h3>

AI business accelerators

Speed your adoption of AI and automation using our pre-configured solutions for business processes.

Clinical support services

Gain expertise in utilization management, case management and population health management with access to a global talent pool.

Cognizant Neuro® Business Processes

Simplify and accelerate automation adoption, integrate and orchestrate resources and see faster returns.

Customer experience management

Get support through omnichannel contact services designed to improve customer satisfaction score (CSAT) and Net Promoter® Score.

Digital revenue cycle management services

Outsource your revenue cycle management (RCM) services using Cognizant’s proprietary RCM workflow technology.

Service options include:

Full-cycle RCM
Front-end RCM
Middle-office RCM
Back-office RCM
Complex claims
Clinical administration services

Employee experience enterprise services

Find out how you can deliver persona-based employee experiences at scale.

Finance and accounting

Generate new business value from finance and accounting.

Intelligent automation services

Get your business future-ready with industry-aligned IT and process automation solutions.

Marketing operations

Increase speed, efficiency and insights to get better marketing ROI.

Omnichannel customer care

Deliver the intuitive experiences customers require.

Payer services

Streamline your daily workflows with Cognizant services.
Options include:

Enrollment and member services
Provider data management (PDM)
Claims administration

Pharmacy benefit management

Enable modern pharmacy benefit management (PBM) operations and claims processing using Cognizant services.
Options include:

Claims services
Benefits configuration
Front-end mailroom services
Mail order processing

<p class="mb-0">Disclaimer: Net Promoter®, NPS®, NPS Prism®, and the NPS-related emoticons are registered trademarks of Bain & Company, Inc., NICE Systems, Inc., and Fred Reichheld. Net Promoter ScoreSM and Net Promoter SystemSM are service marks of Bain & Company, Inc., NICE Systems, Inc., and Fred Reichheld.</p>

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Our services

<h3>Resources</h3>

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An introduction to generative AI in healthcare

Explore how generative AI and large language models have the potential to transform healthcare.

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Critical components of an intelligent automation strategy

Learn how to maximize efficiency as you digitize processes to streamline your operations—it doesn’t have to be that complicated.

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Combating infectious disease in the future

Advanced technologies and behavioral changes can help us mitigate the impact of a global health crisis. Here’s how.

Two men standing in a pharmacy, examining a product on the shelf together

How intelligent automation tackles the US opioid crisis

Explore how combating the opioid crisis through intelligent automation connects payers, government, pharmacy and members, as well as the promising outcomes from the program.

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Resources

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VALUE

Improved experiences, future-ready processes, innovation

VALUE

Improved experiences, future-ready processes, innovation

Cognizant transforms healthcare with automation, AI and advanced analytics. Our global workforce of experts drives innovation, productivity, cost efficiencies and revenue growth, helping companies become modern enterprises powered by cutting-edge technology and expertise.

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VALUE

Rising above uncertainty

VALUE

Rising above uncertainty

Strategically reducing costs and investing in new revenue streams is crucial in volatile times. Modern operations enable businesses to act with insight and speed, predict trends, identify growth areas and balance efficiency with innovation to accelerate growth and scale.

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How we transform organizations like yours

Health plans revamp with AI

HEALTHCARE

Intelligent automation spurs 8X ROI

Major US healthcare organization leverages intelligent process automation to streamline operations enhancing member experiences, improving efficiency and reducing costs.

Siemens transforms CX globally

LIFE SCIENCES

Siemens transforms CX globally

A reimagined customer service-driven strategy enables Siemens Healthineers to streamline operations leading to 30% reduction in licensure costs and 100% SLA adherence.

RPA speeds healthcare revenue cycle management

HEALTHCARE

RPA speeds healthcare revenue cycle management

A leading RCM service provider turned to Cognizant to help streamline its benefits eligibility verification process for healthcare providers.

Automating IT claims processing

HEALTHCARE

Automating IT claims processing

A major health plan transforms its operations with a world-class automation platform that processes claims faster, allowing it to focus on product development and customer experience.

Health plans revamp with AI

HEALTHCARE

Preventing care with a dose of AI

Reimagining processes with AI to create new experiences and outcomes will enable payers to differentiate their offerings for employers, providers and consumers.

BPaaS yields better pricing accuracy

HEALTHCARE

BPaaS yields better pricing accuracy

A healthcare organization with 1M+ members gains a competitive edge with a cost-effective strategy that simplified operations, increased pricing accuracy and improved customer experience.

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Featured work

<h3>Analyst accolades</h3>

Everest Group’s Utilization Management Operations PEAK Matrix® Assessment 2025

Cognizant named a Leader in Everest Group’s Utilization Management Operations PEAK Matrix® Assessment 2025

Cognizant has been recognized as a Leader in Everest Group’s Utilization Management Operations PEAK Matrix® Assessment 2025.

PEAK Matrix Badges

Cognizant secures top spot in Everest Group Healthcare BPaaS PEAK Matrix® 2024

Everest Group has named Cognizant the highest ranking service provider in its inaugural Healthcare Business Process Services (BPaaS) Solutions PEAK Matrix® Assessment.

Cognizant named a Leader in MedTech Operations PEAK Matrix® Assessment 2023 by Everest Group

Cognizant earned the highest designated Leader position among all participating providers, and the highest marks in the categories of market adoption, innovation and investments.

Read the report

PEAK Matrix Badge for clinical and care management operations 2023

A leader in clinical and care management (CCM) operations

Cognizant’s diverse in-house medical talent pool, robust suite of services, flexible BPaaS for care coordination and focus on quality improvement services helped catapult us into the leaders category in the Everest Group’s Clinical and Care Management Operations Services PEAK® Matrix 2023.

Read the report

PEAK Matrix Badge for revenue cycle management 2023

Cognizant named a Leader in Everest Group’s Revenue Cycle Management (RCM) PEAK Matrix

Cognizant was singled out as one of few providers able to deliver the full RCM suite as a result of our deep technical prowess, broad healthcare expertise, robust partner ecosystem and clearinghouse capabilities.

Read the report

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Awards and recognitions

Take the first step

Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital healthcare solutions is vast and growing. Our expertise in healthcare IT services enables us to integrate cutting-edge technology seamlessly into your operations.

Let’s talk about how digital healthcare solutions can work for your business.

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