Lower Healthcare Costs with Clinical Engagement
Transform Your Care Management to Deliver Better Member Outcomes
Guiding Members Through Their Healthcare Journeys
Optimize Member Experience Through Intuitive 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 gives your members the personalized, intuitive care navigation support they need. Our clinical experts empower members to make smarter decisions, help reduce unnecessary expenses, and improve healthcare outcomes—all in one easy-to-access platform.
Ensuring the Right Care, at the Right Time, at the Right Cost
Empower Better Decision-Making for Better 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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Explore the Valenz Clinical Engagement Solution
Providing Patients the Support They Need, When They Need It
By combining expert guidance, proactive intervention, and personalized support, the Valenz Clinical Engagement Solution delivers significant ROI while enhancing the overall healthcare experience.
Utilization Management (UM)
Facilitate early identification of high-risk, high-cost cases to prevent rehospitalization and reduce costs through Utilization Management. Once notified of a new member diagnosis, our expert nurses conduct a clinical review to determine medical necessity and ensure alignment with the most appropriate level of care.
Vālenz Health® has earned URAC accreditation for Health Utilization Management.
Get pre-certification and coverage verification
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Identify and refer case management
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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.
Lower costs for employers and members
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Streamline the path to good health
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Access patient-focused support
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Evaluate prescription drugs
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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 cost savings by steering members to network providers through our Case Management solution. Our program matches qualified members with an experienced, dedicated Nurse Case Manager to coordinate care and provide personalized guidance throughout treatment.
Disease Management (DM)
Combat chronic illness, reduce costs, and help members live healthier, more productive lives with Disease Management. Valenz provides the tools for effective self-management to improve clinical outcomes and reduce spending on the most expensive and prevalent chronic health conditions, such as asthma, diabetes, hypertension, chronic kidney disease, and coronary artery disease.
Combat effects of chronic illness
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Enable patients to self-manage their care plan
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Keep medical expenses low
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Ensure comprehensive patient guidance
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Our Disease Management provides the support members need to make smarter lifestyle choices that help them achieve and maintain better health—all while lowering high healthcare costs.
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.
Yielding an average ROI of 8:1, 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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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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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.
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.