Financial Risk Management & Health Plan Operations
Take on Full-Risk or
Launch a Health Plan?
Conifer Payer Operations for Providers
Conifer Payer Operations for Providers helps you with the necessary technology infrastructure and management oversight to support licensed health plan operations. If you already have a health plan solution, our platform can help you improve performance so you can focus on delivering quality care and pursuing strategic opportunities. Our centers of excellence perform claims operations, eligibility and enrollment, care management (including prior authorization and concurrent review), network management, and customer and provider relations services to meet the needs of your participants and providers.
We have URAC accreditation for health utilization management, case management, and transitions of care services.*
We are URAC vendor-certified for case management, disease management, and health utilization management.*
*URAC accreditation through Conifer Care Continuum Solutions, a Conifer Health Solutions company
- Launch a health plan or receive delegated risk from a payer
- Achieve efficiencies by leveraging Conifer Health’s expertise and experience with larger health plan operations
- Tailor your health plan solution to meet relevant claims processing requirements
- Focus on the delivery of quality care to members, while managing the financial risk associated with the cost of care
“We knew the sooner we had a platform in place to help guide us in managing the population, the sooner we could achieve the goals of our value-based contracts”
Vice President of Administration,
KentuckyOne Health Partners