Care Management Solution for Health Plans
Jiva is your one-stop shop for a comprehensive set of solutions for care management, benefits administration, process automation, organizational optimization, and efficiency across the enterprise.
Our care management solution is powered by sophisticated data integration that delivers a clear view into enterprise insights and AI-powered analytics that work transparently to deliver advanced and specific insights into cost and quality.
Intelligently automated “next best action” workflows enable care management teams to support better care at lower costs while delivering an outstanding member experience. We embed evidence-based clinical content and best practices into workflows crafted by experienced care managers with extensive nursing experience. Updates are made annually to eliminate unwanted variation and ensure high-quality, high-impact results every time.
Key Solutions for Health Plans
Jiva Healthcare Enterprise Management Platform
Your one-stop shop for a comprehensive set of practical, AI-powered solutions to today’s—and tomorrow’s—challenges. Empower your teams to accurately administer benefits, manage the organization, and profitably run the business for the best outcomes for everyone.
HealthUnity™ Data Interoperability
Apply analytics to transactions to indicate potential care gaps or identify member populations/providers who should receive specific updates—all while supplying enriched data feeds to other payers and facilitating greater continuity.
HealthUnity™ Smart Authorization Gateway, our ePA solution
A powerful, FHIR-based interoperability gateway that facilitates payer compliance with the Patient Access API, Provider Directory API, Payer-to-Payer Data Exchange requirements of the Final Rule, and more.
SDOH Social Care Platform
This groundbreaking platform aggregates data from a wide variety of government, claims, and assessment sources to provide accurate indications of social risk at a community and personal level.
Jiva Care Quality Navigator
A forward-thinking performance monitoring and analytical solution with an embedded omnichannel workflow that centralizes HEDIS and CMS Stars quality program data, improves care gap closure rates, and empowers value-based care reporting.
Jiva Risk Adjustment (RA) Navigator
Your solution for hierarchical condition categories (HCCs) visualization and analysis. The RA Navigator brings risk adjustment data into the complete member profile, empowering care managers to act.
Care, Disease, and Utilization Management
Whether you are pursuing broad-based population health initiatives, focusing on a handful of specific disease states, or refining your approach to utilization management, the care management capabilities in Jiva drive workflow efficiency, quality, and cost savings.
ZeOmega is #1 Best in KLAS for Payer Management Solutions 2022 and 2023
Impact of the New CMS Healthcare Interoperability Rules | ZeOmega
Much of the direction of the 2020 proposed rule is in the new proposed rule, particularly the sharing of prior authorization decisions/status with patients.
AbsoluteCare Selects ZeOmega for Chronic Care Management for High-Risk Patient Populations
ZeOmega announced today that value-based integrated healthcare provider AbsoluteCare has selected ZeOmega’s Jiva platform to fulfill its needs for comprehensive care management, utilization management, and clinical assessment support.