HealthEdge

Health plans face significant pressure to improve interoperability, efficiency, and value-based care operations. Meanwhile, the growing use of artificial intelligence (AI) across the industry is resetting industry expectations for workflow automation and flexibility. To help manage the industry's growing complexity, health plan leaders are integrating and modernizing their technology solutions. Discover six key components of a modern payer technology stack, and how payers are leveraging Business Process as a Service (BPaaS) to achieve their goals. Download the report: http://spr.ly/6043hH0gW

In our latest #EmployeeSpotlight, we asked Anshuman Dewangan, Lead Machine Learning Engineer, about the culture at HealthEdge. Watch to hear his thoughts! #workatHealthEdge

For health plan leaders, tight budgets and limited resources can make it challenging to prioritize quality improvement measures. One health plan turned to HealthEdge® to develop and execute a multi-faceted strategy focused on three core objectives: 1. Improve star ratings with more robust reporting 2. Enhance risk score accuracy 3. Strengthen decision-making using advanced analytics See how this strategic partnership helped the payer achieve and maintain a 4+ Star Rating for three consecutive years. Read the case study: http://spr.ly/6046BBALin

When it comes to provider data management, health plans must overcome common challenges—like data silos, inaccuracies, regulatory requirements, and administrative costs. With an integrated Provider Data Management solution, health plans have access to a single source of truth that: -Delivers accurate information to members and health plan administrators -Improves operational efficiency, and -Enhances payment accuracy Download the report from the International Data Corporation (IDC) to learn more about the benefits of a next-generation solution like HealthEdge® Provider Data Management: https://lnkd.in/enSHv-FT

For health plans, managing multiple vendors can create compounding inefficiencies that drive up costs and slow decision-making. Transitioning to a single, integrated ecosystem helps payers address these challenges from the source rather than manage symptoms as they arise. "Scalability isn't just about whether your systems can handle more volume. It's about whether your operations team can handle more complexity. Integrated platforms reduce that complexity at the source." -HealthEdge® Vice President of Delivery See how an integrated technology ecosystem can transform areas like: -Claims intake -Adjudication volume -Eligibility and enrollment processing Read the article to learn more: http://spr.ly/6044BBxuX2

We're #hiring a new Senior People Business Partner in United States. Apply today or share this post with your network.

We're #hiring a new Director, FP&A in United States. Apply today or share this post with your network.

Adopting a new Core Administrative Processing System (CAPS) is a significant undertaking, and can be intimidating for health plans to approach. But many legacy CAPS weren't built to keep up with modern demands for integration, automation, and transparency—causing payers to look for new solutions. See 5 key signs that your health plan has outgrown your existing CAPS (and how you can move forward with confidence): http://spr.ly/6042BBxuHk

We’re excited to continue growing our teams with weekly #HotJobs — especially as HealthEdge and UST HealthProof move forward as a newly combined team. Together, we’re proud to offer even more opportunities across the organization. To explore our latest openings, visit the direct links for easy access: https://lnkd.in/gy8JtgqG https://lnkd.in/gSVxCcTQ And remember, you can get the early inside scoop on our weekly Hot Jobs by following us on Instagram (healthedge_software)! #workatHealthEdge #hiring #wearehiring #workatHealthProof

Every premium dollar a health plan collects must be carefully divided to ensure a health plan can remain competitive, meet regulatory obligations, and invest in better care for its members. Two metrics sit at the center of this practice: Medical Loss Ratio (MLR) and Administrative Loss Ratio (ALR). Discover how HealthEdge® solutions help health plans optimize MLR and ALR performance through operational efficiency, intelligent automation, and platform integration. Download the brochure: http://spr.ly/6047BBQYKH