Jiva for Commercial Risk Management

Manage the Health of Your Population While Personalizing Care One Member at a Time

Commercial risk management organizations are experiencing rapid change in how they do business. Consumerism and shifting regulatory mandates are among the many factors transforming the healthcare landscape and escalating pressure to control costs and premiums while increasing care quality. Jiva delivers all of the tools commercial risk management organizations need to manage the overall health of their populations while consistently and efficiently personalizing the care experience one member at a time. 

Case Study

Qualis Health Enhances Business Process Workflows by Combining Lean Expertise with ZeOmega Rules Engine Intelligence

Innovative Approach Combines Lean Expertise with Rules Engine Intelligence to Streamline Complex Workflows to Improve Efficiencies and Lower Costs

With Jiva for Commercial Health Plans, you can:

    • Integrate medical management capabilities, including utilization, case, disease, medication and behavioral health management
    • Improve staff efficiency and efficacy through intelligent workflow automation
    • Compete in today’s employer market and expand into the consumer market as the new exchanges take hold
    • Support individuals and small groups with chronic conditions and high-risk behaviors
    • Meet accreditation and regulatory requirements, including medical loss ratio
    • Leverage an NCQA-certified platform with evidence-based content covering over 24 disease conditions
    • Involve patients and caregivers with patient activation and engagement tools integrated into the care management process