Power of the Ecosystem
Care Navigation & Management
Transparency into Ecosystem Data
Valenz integrates member-centric services with data-driven insights, connecting the dots with personalized service and guidance for high-quality care and improved outcomes. We engage early and often with results-driven education, support and services to avoid more serious and costly health events.
Member enrolls in the health plan.
Access Solution Suite delivers quality-first provider networks and reimbursement strategies with cost-saving, risk-reducing services to replace your high-cost contracted network plan – and you choose which network model will best serve your business and member needs.
Member seeks care services.
NaVcare provides concierge-level member guidance, directing care to in-network providers for better savings, outcomes and experiences. Also includes telehealth integration and referrals to care management.
Member is diagnosed and needs treatment.
RN-led, triple URAC-accredited care management targets the right care before services are rendered. Improve quality of care and maximize savings with personalized Case Management, Utilization Management and Disease Management.
Member is prescribed Rx therapy and needs close monitoring.
Wraparound care management services optimize care with specialty pharmacy benefit solutions, remote monitoring for chronic conditions, specialized care management for oncology, cardiology, diabetes, maternity and more.
Member’s claims are submitted for payment.
Protect payment integrity for your business and out-of-pocket costs for your members with our complete set of tools and services for systematic claim review, expert bill review with provider sign-off, claim and network repricing, stop loss group captives, and balance billing support.
Member and health plan need costs to stop rising every year.
Through the power of the ecosystem, which includes unparalleled data transparency and analytics across the life cycle of every claim, Valenz continuously uncovers opportunities for improved quality and utilization to lower costs. Reduce health spending year over year compared to ever-rising BUCAH plan costs.
With Valenz, you can have a healthier member population while also achieving plan and member cost savings… year after year. For the tools and transparency you need to make cost-effective, quality-first decisions, let’s find your path to smarter, better, faster healthcare today.
With a suite of fully configurable solutions integrated into one ecosystem strategy, the Valenz Healthcare Ecosystem Optimization Platform offers extensive visualization into cost, quality and utilization opportunities, along with a consistent omnichannel member experience.
See how we partnered with a collaborative of three schools representing 600+ members in deploying a health plan replacement to change the rising cost trajectory and improve quality of care.
The Valenz V-Rated Solution identifies the risks affecting the plan and aligns them with the summary plan description and cost containment solutions. Ultimately, V-Rated leverages alignment, balance and transparency to bring back fiduciary responsibility while allowing an appropriate stop loss rating.
See the results of a roundtable conversation among executive team members at Valenz Health and Certus Management Group regarding stop loss as the foundation of building a self-funded plan.