Health Plans

CitiusTech builds end-to-end solutions for mobile-first engagements, personalized member analytics, self-service portals and omni-channel member management. We have an extensive portfolio of consulting, engineering, data and analytics offerings that enable payers to transform member experience, create longitudinal member profiles and drive member self-management.

We also help drive next gen initiatives – including experience engineering using AI/ML, payment integrity solutions, member profiling and segmentation, performance analytics and member management operations (including CRM platform integration with key workflows like care gaps, member outreach).

CitiusTech helps payers implement core administrative platform for effective alignment to business functions with operational benefits in cost & quality. We also provide digital engineering services across customization, SaaS enablement, data integration and interfacing with third-party technologies (e.g., digital therapeutics, telemedicine, wellness, chronic care management). We also support organizations around intelligent automation (RPA), AI Engineering, MLOps and DevOps automation.

We also have a dedicated payer core Center of Excellence and pre-built accelerators and tools, to enhance project efficiency and speed-to-market.

CitiusTech is uniquely positioned to drive growth and provide sustainable value for payer government business. Our offerings for government programs include omnichannel member engagement, outcome-driven provider engagement, SDoH data and insights, interoperability, compliance programs and audits.

CitiusTech’s portfolio of healthcare consulting, digital engineering services and data accelerators provide payers a competitive edge in a constantly evolving healthcare industry by engaging stakeholders, streamlining organizational workflows and maximizing data access.

We have deep expertise across modern data platforms, payer-provider convergence, personalized care delivery, member analytics, precision reimbursements, value-based analytics and payment integrity solutions.

Payer organizations need to leverage data-driven insights to improve clinical, operational & financial outcomes in a targeted way, to enhance quality of care, utilization metrics, value-based contract performance and member & provider engagement.

CitiusTech provides comprehensive solutions and specialized products that enable health plans to enhance clinical program performance (HEDIS, Stars, risk, PHM), optimize care management workflows, ensure regulatory compliance, establish payment transparency and influence member & provider behavior, to improve outcomes and drive ROI-based campaigns.

CitiusTech enables payers to implement strategic & digital frameworks for effective alignment of business functions, leading to significant improvements in cost and quality – across key processes such as claims management, care management, enrolment & billing, member portals and network management.

We follow design-driven process improvements and Agile delivery methodologies to ensure faster and cost-efficient execution of operations and reduce time-to-market. We also help you develop streaming analytics and AI/ML models for automated, data-driven insights.