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PAYER ANALYTICS & AI
Driving competitive advantage with personalized care
Harness real-time data and advanced analytics to generate value. Leverage CitiusTech’s consulting-led Healthcare analytics services and solutions that align with current data and analytics trends. Enhance operational efficiency and member outcomes with real-time administrative visibility, risk stratification, data-driven decision-making, scalable VBC programs, and GenAI.
AI Consulting &
Ops-as-a-Service
BI modernization
Risk Stratification & Predictive analytics
Value based care Insights
STAR/ HEDIS intelligence
Price Transparency Analytics
GenAI-enabled solutions
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FEATURES
Achieving optimal performance with real-time insights
Manage regulatory reporting
Improve regulatory reporting with pre-built accelerators like BI migration workbench, consumer experience, analytics and solution for Price Transparency analytics, and our Perform+ suite.
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Ace STAR measures
Streamline decision support to improve performance on STAR measures.
Improve contract negotiation
Renegotiate contracts and achieve referential pricing using a robust metrics library and AI/ML models, ML Ops service design, model validation, DevSecMLOps integration.
Case Study
Leveraging unified data products for enhanced health plan analytics
Consolidating Payer data to build a scalable and sustainable data platform on Snowflake for 3 Mn+ members of a West Coast Blue Plan
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Case Study
Settled suspect FWA claims with AI/ML
Deployed an ML-driven solution with stringent custom scoring metrics to settle FWA-suspect claims. Processed 43% additional claims with over 90% accuracy.
Case Study
Implemented a centralized enterprise business intelligence solution and reporting for next-gen analytics
Designed and implemented a robust analytics platform/Datamart and built Tableau dashboards to analyze 65Mn+ data records and 200+ measures for reporting.
