PAYERS

Powering end-to-end Payer transformation with cutting-edge innovation

Revolutionizing Payer operations to lower costs, streamline processes, improve member experience and outcomes.

PAYERS

Next-gen solutions for an ever-evolving Payer market

The healthcare landscape is undergoing a rapid transformation. The explosion of value-based care models, evolving regulations from CMS, NCQA, and ONC, ever-increasing focus on member and Provider experience, and cost pressures are just some of the disruptive forces impacting Payers today. Payers need to overcome data interoperability barriers, ramp up cybersecurity, and shed the weight of outdated legacy systems. CitiusTech’s cutting-edge technology solutions are helping Payers deliver exceptional member experiences, achieve quality care goals, foster data-driven decision making and thrive in the new era of healthcare. 

PRESS RELEASE

CitiusTech Awarded a 2024 AWS Partner Award

CitiusTech recognized as Industry Partner of the Year in Healthcare & Life Sciences winner, one of many AWS Partners around the globe that help their customers drive innovation

TESTIMONIAL

Tandigm Health’s strong partnership with CitiusTech for driving tech enablement and operational excellence together

PRESS RELEASE

Simplify Healthcare and CitiusTech Announce Strategic Partnership to Enhance Payer Solutions

PRESS RELEASE

CitiusTech’s PERFORM+ clinical convergence platform now includes industry’s first GenAI HEDIS solution

REPORT

CitiusTech named a leader and a star performer in Everest Group’s Payer Digital Services PEAK Matrix®

CUSTOMER SPOTLIGHT

Cambia’s successful digital transformation journey with CitiusTech

OFFERINGS

Transforming Payer solutions for better care

Interoperability

Interoperability

Digital Modernization

Digital modernization

Group (1)

Payer Analytics
and AI

HEalthcare Data

Healthcare
data

Member Experience

Member experience

Quality

Quality management

Provider_modernization

Provider modernization

Value_based care

Value-based
care

Payer_Core

Payer core

CONNECT WITH US

Elevating Payer efficiency with cutting-edge digital solutions and deep expertise

Payer

SUCCESS STORIES

Solving some of the greatest challenges in Healthcare

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Case Study

Reimagined member portal performance through digital modernization

Saved $2Mn in licensing costs while improving application performance by 60% for a leading health plan.

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Case Study

Transformed Healthcare experience with advanced digital front door strategy

Built an omnichannel member engagement platform to uplift member experience for ~4Mn lives and retention.

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Case Study

Boosted interoperability by leveraging clinical data

Enabled 4+ star ratings with $10Mn in annual savings for a large Blue Plan through 4+ years Clinical Data Integration initiative.

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WHY CITIUSTECH

Accelerating digital transformation for Payers

+

Payer customers

%

of the top five national
plans are our customers

+

Blue Plans leverages our
products and solutions

PARTNERS

Creating an ecosystem of limitless possibilities

SERVICES

Shaping Healthcare possibilities with our expertise

PLATFORMS & PRODUCTS

Enhancing value and quality in Healthcare

Perform + realsight

Perform+ RealSight

Make the best of price transparency, reduce operational costs, and comply with CMS Transparency Rules with Perform+ RealSight. An end-to-end data and analytics solution that enhances Healthcare contract negotiations by harnessing publicly available pricing data. It empowers Payers, Providers, and patients with insights for informed decisions. It maximizes price transparency, reduces costs, and complies with CMS rules using Perform+ RealSight.

Perform + Contracts

Perform+ Contracts

Oversee value-based contracts while reducing Provider abrasion, gaining seamless coordination, and operational efficiency. Address coordination challenges and manage Provider performance, goals, and incentives across various quality programs.

perform  and Star

Perform+
Stars

Leverage AI/ML-based decision engines to enhance CMS Star Ratings, offering clearer data insights and decision support amid constantly changing program metrics. Align Provider and member efforts with tools for measure analysis, list prioritization, and performance projections to optimize Star ratings efficiently.

Perform + Datascale

Perform+ DataScale

Enable a scalable enterprise architecture that adapts to business and technological shifts, securing your data strategy for the future. Enhance data credibility while reducing costs and boosting efficiency across your operational framework. Maximize ROI by decreasing application fragmentation and lower administrative burdens to speed up turnaround times, through a comprehensive view of patient data.

Perform  and regulatory

Perform+ Regulatory

Streamline reporting and enhance quality scores with real-time compliance updates and automated workflows, gaining higher compliance rates and operational efficiency.

INSIGHTS

Elevating Payer efficiency with cutting-edge digital solutions and deep expertise

Payers need to rethink modern business model and focus on impactful transformation. Learn more about the different challenges in growth strategies and the strategic path forward.

Payers need to rethink modern business model and focus on impactful transformation. Learn more about the different challenges in growth strategies and the strategic path forward.

Bridging health disparities with analytics and AI

Bridging health disparities with analytics and AI

Empowering Healthcare – The transformation of Prior Auth with intelligent automations

Empowering Healthcare – The transformation of Prior Auth with intelligent automations

Evolution of Personalized Care: From Cohort Segmentation to Precision Medicine

Evolution of Personalized Care: From Cohort Segmentation to Precision Medicine

Payers need to rethink modern business model and focus on impactful transformation. Learn more about the different challenges in growth strategies and the strategic path forward.

Payers need to rethink modern business model and focus on impactful transformation. Learn more about the different challenges in growth strategies and the strategic path forward.

Elevating Value-Based Care: The indispensable role of impactful technologies.Explore the potential of VBC to optimize costs and the key role of technology in driving its success.

Elevating Value-Based Care: The indispensable role of impactful technologies.Explore the potential of VBC to optimize costs and the key role of technology in driving its success.