Healthcare payor services

Improve operational efficiency

Modernize your operating model and optimize processes like claims payment, enrollment, and care management for increased efficiency to improve quality outcomes.

Elevate the member, provider, and broker experiences

Optimize interactions with key stakeholders using AI and communications to provide value at each touchpoint.

Enhance your enterprise technology solutions

Implement, modernize, and connect your data assets across platforms and domains, CRM and ERP design to enable deep business and IT insights, and efficient health plan operations.

Achieve financial excellence

Increase profitability and manage financial risk with strategic programs that address long-term medical loss ratios (MLR) and balance product mix to improve retention and grow market share.

Expand value-based care

Align payer and provider incentives to lower administrative and medical expenses and move toward a more collaborative relationship. Enable easier care delivery and financing for the member/patient.

Build a high-performing organization

Promote continuous learning, technology adoption, and innovation to empower your people to adapt and thrive in an ever-evolving healthcare landscape. Enable more effective operating models to address the needs of our changing workforce.

Facilitate payer-provider collaboration

Analyze and innovate provider relationship management, including identifying ways to streamline interactions, enhance care coordination for your key care programs, simplify payment policy, and be the easiest to do business in your market for your partner providers.

Expand your business

Assess and improve your health insurance product portfolio, ancillary services offerings, and TPA relationships to optimize growth in target markets. Consider partnership options to realize your growth and financial goals vis-à-vis your competition.

Core platform implementation

Whether you are implementing or upgrading your Core Administrative Processing System (CAPS) or in need of an assessment of your configuration design to drive efficiency or enhance quality, or the development of a new data interface, Huron’s team understands deeply all of the leading vendor packaged applications allowing us to quickly design and deploy solutions providing the greatest advantage and fastest return on investment.

Core platform testing

A core processing platform touches every aspect of the health plan members’ experience. Therefore, commitment to quality is of utmost importance. Huron’s testing and quality assurance services provide industry leading practices to our clients as they seek to improve claims and service outcomes, configuration builds, and overall performance, supplying a superior experience to your members, groups, and providers.

Core platform managed services

Huron’s Business and IT Process “as a Service” offerings allow our clients to operate their core platforms at a lower cost without any loss in health plan institutional knowledge. Our core team leaders bring decades of experience operating back-office processes on numerous industry platforms.

Data and integrations

Interoperability remains a major requirement for Payors nationwide. Huron’s data management and analytics services supply practical expertise for our health plan clients. We focus on health plan data management and interaction with ecosystem partners to deliver the value of open data standard platforms, such as FHIR, etc.