Health Plans

Enabling you to improve member outcomes

We help health plans achieve sustainable operational efficiencies

With rising costs of care and fast-changing regulatory mandates, health plans need to invest in technology solutions that drive value-based care. They face multiple challenges around risk stratification, population health, accountable care and regulatory challenges like HEDIS® and STAR.

CitiusTech is well-positioned to help health plans drive clinical value chain excellence. CitiusTech offers a comprehensive suite of services, platforms and solutions across a wide range of payer needs. Its BI-Clinical platform for healthcare BI / analytics is NCQA certified for all HEDIS 2018 performance measures. CitiusTech’s SCORE+ for HEDIS is an end-to-end suite for real-time HEDIS reporting, provider collaboration and accelerated gap-closure.

CitiusTech also provides best-in-class management consulting expertise through FluidEdge Consulting, which focuses on strategy, operational analysis, regulatory compliance, quality programs, technical evaluation and project management. Through a strong health plan network, FluidEdge has access to a large number of health plan-focused resources with knowledge of core claims processing systems, provider data management systems and care / medical management systems.

Health Plans & Payers: Driving Clinical Value Chain Excellence

Health Plan & Payers, Managed Care Organizations, Disease Management Companies, Payer Services Organizations


SCORE+ for HEDIS is an end-to-end HEDIS performance management suite to help healthcare organizations accelerate quality reporting and enhance collaboration for gap closure.

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Healthcare Payer Technology Services, CitiusTech

Solution Highlights:

  • NCQA certified for all HEDIS 2018 measures

  • Comprehensive reporting for clinical, financial and operational KPIs

  • Powerful Chase Intelligence capabilities to identify high priority chases


  • Mobile / web-based chart abstraction for automated data abstraction
  • Highly configurable dashboards for real-time monitoring and quick closure of gaps-in-care
  • Near real-time reporting with high-performance rules engine

Health Plans and Payers: Healthcare Technology Platforms

CitiusTech offers tools and accelerators that enable health plans and ACOs leverage clinical data to manage shared risk, optimize operational performance, engage consumers and enhance population care.

Healthcare Payer Technology Solutions, CitiusTech

NCQA 2018 Certified healthcare BI / analytics platform with 750+ clinical, financial, operational & regulatory KPIs - largest CQM library, and self-authoring Rules Management Module (RMM).

A suite of predictive analytics tools and data science / statistical services to predict high-risk population, severity prediction, customer lifetime value prediction, geo-spatial segmentation, treatment compliance, accuracy of diagnosis etc.

Healthcare data integration and management platform to accelerate MDM and automated analytics. Portable to any data platform, including Hadoop, NoSQL, MPP and RDBMS.