Control Healthcare Costs with Proactive Clinical Engagement
Transform Your Care Management to Deliver Better Member Outcomes
Guiding Members Through Their Healthcare Journeys
Optimize Member Experience Through Intuitive Medical Care Management
Tired of the rising costs, fragmented care navigation, poor chronic condition management, and other challenges facing your health plan members?
Care management is the solution you need — and no one does it better than Vālenz Health®.
Delivering a comprehensive suite of care management services, the Valenz Clinical Engagement solution helps TPAs, employers, and health plans proactively identify high-cost care opportunities, engage members earlier, and influence care decisions before costs escalate.
By integrating Utilization Management, Case Management, and Disease Management, we connect clinical expertise with measurable financial outcomes to deliver smarter, better, faster healthcare.
Ensuring the Right Care, at the Right Time, at the Right Cost
Empower Better Decision Making for Higher Cost Containment
Through personalized, intuitive care navigation, Clinical Engagement supports smarter, more-informed decision making by members, reducing unnecessary healthcare utilization and spend without compromising care quality.
By integrating clinical insight with network optimization and outreach, we ensure every member receives the right care at the right time — while simultaneously lowering total plan costs for payers.
Our key to success? A proactive, integrated approach that combines:
Utilization Management (UM)
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Case Management (CM)
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Disease Management (DM)
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Integrated Utilization, Case, and Disease Management
Influence Care Earlier for Lower Healthcare Costs
By combining expert guidance, proactive intervention, and personalized support, the Clinical Engagement solution delivers significant ROI while enhancing the overall healthcare experience.
Get timely pre-certification and coverage verification
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Customize to support your plan design
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Eliminate unnecessary costs
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Ensure prompt service for members
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Utilization Management facilitates high-quality care while eliminating expenses tied to unnecessary, unproven, or excessive treatments.
Valenz primarily utilizes MCG and NCCN guidelines to make clinical decisions regarding precertification of services. For questions or additional details regarding criteria, please contact our Utilization Management team at carecustomerservice@valenzhealth.com, (877) 608-2200, or mail a written request to 22601 N. 19th Ave Suite 131 Phoenix, AZ 85027.
Lower costs for employers and members
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Engage earlier for higher savings
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Offer direct access to experienced clinicians
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Support better member advocacy
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Through proactive engagement and collaboration, we help manage costs and quality of care to reduce ER visits, hospitalizations, and other high-dollar claim events.
Case Management (CM)
Improve quality of care and maximize savings with experienced nurse case managers that guide members through complex and high-cost care episodes.
Disease Management (DM)
Combat chronic illness, reduce costs, and help members live healthier, more productive lives with Disease Management. Ongoing engagement and prevention-focused support helps members avoid high-cost claims associated with conditions such as asthma, diabetes, hypertension, and more.
Prevent and manage the effects of chronic illness
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Support self-management with ongoing, personalized coaching
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Enable long-term cost containment
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Disease Management provides the support members need to make smarter lifestyle choices that help them achieve and maintain better health for the future — all while lowering high healthcare costs today.
Full Clinical Engagement Suite
Our full Clinical Engagement suite allows you to cover all your healthcare bases by combining Utilization Management, Case Management, and Disease Management.
The full Clinical Engagement suite helps optimize health outcomes throughout the entire care journey, minimizing the high costs of healthcare without compromising care quality.
Valenz Bluebook
Easily package Valenz Bluebook with the Clinical Engagement suite to deliver clear, actionable cost and quality data that empowers both members and employers to make better healthcare choices.
All Your Health Insurance Solutions on One Platform
Explore the Vālenz Health® Integrated Platform for Simplified Healthcare
Seamlessly unite member experience, payment integrity, provider quality, and plan performance with our integrated platform. Discover how we optimize the utilization of high-value healthcare across the entire member journey.
Greater Efficiency, Improved Care Quality
Explore the Vālenz Health® Difference
Multi-State Health Plan
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Children’s Hospital
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Info Box
We found opportunities for nearly 14% in additional savings beyond the PPO discount and secured provider signoff, delivering our client $129,648 in net savings.
High-Dollar Claims
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Info Box
Our line-by-line bill review for a catastrophic claim delivered $93,798 in net savings above the PPO discount, with 5% lower fees than the TPA vendor and no balance billing to the patient.
Clinical Engagement FAQs
Your Frequently Asked Questions, Answered
Ready to Simplify Self-Insurance?
Your Journey Starts Here
Connect with a Valenz team member to explore the difference our solutions can make for you.
