Population Health Management Solution for Medicaid
Support high-quality care with appropriate cost controls while meeting specific state-by-state regulatory requirements
Every Medicaid program presents a unique set of requirements, processes, and rules for everything from member assessments to utilization and care management. With experience across multiple state programs, ZeOmega offers the knowledge and flexibility to help organizations meet the specific requirements of each managed Medicaid plan.
Enabling high-quality care for vulnerable populations that is both compliant and cost effective is not easy, and two big challenges stand out:
Understanding the subtle combinations of factors that are really driving outcomes and gaps in care.
Intervening effectively with limited staff, high turnover, and constrained budgets.
ZeOmega solutions excel at addressing these key managed Medicaid challenges. With the industry’s most sophisticated AI-powered population health analytics that incorporate a broad range of built-in social determinant factors, we enable care management teams to find the right interventions for the cost/quality drivers in your Medicaid communities.
We also embed evidence-based clinical content best practices, and “next best action” workflows created by experienced care managers with extensive Medicaid-specific nursing experience and updated yearly. This makes it possible to optimize care teams to follow step-by-step automated workflows to eliminate unwanted variation for high-quality, high-impact results every time.
Key Solutions for Medicaid
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.
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.