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TriZetto Healthcare Products / Care Management

Linking people to improve healthcare

The most successful care management programs optimize the connections among care managers, members and providers. The result: personalized healthcare interventions, enhanced outcomes, improved quality of care and reduced costs. 
Achieving these goals can be difficult, but automating and integrating as many processes as possible can make meeting them feasible.
Because our CareAdvance and Value-Based Benefits solutions share a member portal, these solutions can use the same rules. This approach automates your plan’s workflows and leverages real-time coordination between systems. While both are core product-agnostic, each solution can also be fully integrated with both Facets® and QNXT solutions.   

Our approach to care management starts with Clinical CareAdvance® and CareAdvance provider®, solutions that together deliver full care management capabilities across utilization, case and disease management. These solutions transform care management into an automated, data-driven activity that delivers more targeted, effective health information and wellness campaigns. The outcome is improved interactions with members and providers. 

Our Value-based benefits solution, the second part of our care management portfolio, provides an automated and integrated solution for designing and administering member incentive programs. Our newest care management solution, TriZetto® Touchless Authorization Processing (TTAP), enables fully automated prior authorization via provider portal, including integrated clinical criteria and pre-built integration to QNXT™.

Our care management solutions helps healthcare organizations enhance revenue growth, drive efficiency and improve cost and quality of care. Your benefits include:

  • Increased efficiencies via a streamlined utilization, case and disease management experience.
  • Reduced risk and total cost of ownership by integrating both Facets and QNXT.
  • Efficient workflows through consolidated application screens and an interface that allows easy navigation and access to important member information.
  • An open analytics platform that you can customize and integrate them with any advanced analytics solution to improve clinical outcomes.
  • The ability to engage members to manage chronic conditions effectively and improve overall health status by participating in programs for chronic conditions, prevention and wellness.   

Products

Clinical CareAdvance®

Automated workflows and member-provider outreach

Value-based Benefits

Complete solution for implementing member incentive programs

CareAdvance Provider®

Integrating utilization management efficiencies into provider workflows

TriZetto® Touchless Authorization Processing (TTAP)

Reduce costs and improve patient experiences with automated authorization

Lines of business

Commercial

Our comprehensive, flexible and scalable core administrative solutions enable the digital transformation required for success in the commercial market.

Individual & small group

Support for the economic advantages and efficiencies.

Specialty

Get flexible IT solutions to address your unique business requirements with customizable functionality.

 

 

Medicare

Build functionality that adapts to meet the complexities and demands of the Medicare Advantage market.

Medicaid

Build capabilities that adapt to meet the complexities and demands of the Managed Medicaid market.

Duals

Apply flexible solutions that streamline the coordination of multiple compliance requirements and ease administration burdens.

Related services

Business process services

Services that offer meaningful business outcomes.

Business consulting

Benefit from our unparalleled healthcare business consulting expertise.

Next-gen technologies

Put next-generation technologies in place that build a stronger, more agile business and lay the groundwork for future AI and automation initiatives.

Infrastructure services

Get services that ease the strain of managing your infrastructure so you can focus on managing your business.

IT professional services

Take advantage of our unrivaled resources and healthcare expertise to meet your IT business needs.

Services/Benefits administration

Apply our proven software, technology, expertise and tested methodologies to manage your business more effectively.

Business process-as-a-service

Our integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

Contact us

At Cognizant, we are here to provide you with more information about our TriZetto Healthcare Products software and service solutions and answer any questions you may have.

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