carrot carrot carrot Change Centers x cognizanti collaborators create-folder Data Science Decisive Infrastructure download download edit Email exit Facebook files folders future-of-work global sourcing industry info infographic linkedin location Mass Empowerment Mobile First our-latest-thinking pdf question-mark icon_rss save-article search-article search-folders settings icon_share smart-search Smart Sourcing icon_star Twitter Value Webs Virtual Capital workplace Artboard 1

Please visit the COVID-19 response page for resources and advice on managing through the crisis today and beyond.

Harness Medicare Markets


TriZetto Healthcare Products provides an extensive portfolio of capabilities to meet the specific needs of your Medicare Advantage business.


Our experience and capabilities will help you effectively address your Medicare administration needs, revenue management and data submission so you can respond quickly to evolving mandates and regulatory requirements.

The number of people receiving Medicare benefits is projected to rise nearly 60% by 2030. For health plans serving this market, long-term success demands increased system efficiencies to support this rapid growth. Medicare market success also requires tools that enable continued compliance with changes in Medicare reporting rules, complex Centers for Medicare and Medicaid Services (CMS) regulations and the Medical Loss Ratio (MLR) requirement.

With more than 30% of all Medicare Advantage and Part D lives processed on our core systems, the Cognizant line of TriZetto Healthcare Products provides an extensive portfolio of capabilities to meet the specific needs of your business. This comprehensive and highly effective combination of advanced technology and services offerings can help you lower administrative costs, increase speed to market and decrease total cost of ownership. Other capabilities work to:

  • Automatically enroll new members
  • Generate, edit and reconcile required Risk Adjustment Payment System (RAPS) and encounter data submissions
  • Accurately reconcile Medicare members
  • Enhance risk score accuracy to receive proper reimbursement
  • Identify where members have Hierarchical Condition Categories (HCCs)
  • Utilize analytics to improve your Five-Star Quality Rating
  • Coordinate and improve care for Medicare members
  • Manage new reimbursement and care models


Core Administration

Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.

Cognizant Interoperability Solutions

Offers end-to-end solution that pairs modular SaaS products with industry-leading strategic consulting to connect disparate systems, standardize data and enable secure, authenticated access in real-time.

TriZetto® TranZform®

Enables shared decision-making, communication and collaboration as a multi channel, modularized solution.

Provider Network Management

Automates pricing scenarios to provide the best value to payers, providers and patients.

Quality Management

Enables payer/provider collaboration to reduce costs and drive overall quality improvement.

Trading Partner Management

Manages EDI trading partners with one cost-effective, cloud-enabled technology service.

Care Management

Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.

Optimization Software Products

Automate and simplify operational tasks associated with our core healthcare technology solutions, Facets and QNXT.

TriZetto Elements®

Extend the functionality of your core system by providing critical capabilities from enrollment through risk adjustment, to efficiently administer government solutions.

Portal Technology

Automates transaction processing and information exchange between payer organizations and their external constituents.


Business Process Services

Services that offer meaningful business outcomes.

Business Consulting

Unparalleled healthcare business consulting expertise.

Next-Gen Technologies

Leverage the power of next-generation technologies to build a stronger, agile business.

Infrastructure Services

Services to manage your infrastructure so you can manage your business.

IT Professional Services

Unrivaled resources and healthcare expertise to meet your IT business needs.

Services/Benefits Administration

Software, technology, expertise and proven methodologies to help you manage your business more effectively.




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.

Please Enter Valid First Name
Please Enter a Valid Email Address
Please Enter Valid Company Name
Please Enter Valid Contact Number
Please Input the Region
Please Input the Inquiry Type
Please Input the SubInquiry Type
Please Enter A Message

Thank you for your interest in Cognizant.

We’ll be in touch soon.