Care Management Services
Proactive outreach. Coordinated care. Better outcomes at scale.
Sagility helps health plans identify members who need support, engage them in the right programs, and coordinate care across clinical and operational teams. Our tech-led workflows and experienced clinicians improve continuity of care, close gaps, and reduce avoidable utilization.
Overview
As part of Payer Clinical Services Suite, our Care Management services help health plans stratify risk, coordinate interventions, and support members across the continuum of care. We combine clinical expertise, member-centric engagement, and workflow enablement to improve outcomes, elevate the member experience, and drive measurable value.
Risk Stratification & Case Identification
- Risk scoring to identify rising-risk and high-risk members
- Referral intake and eligibility validation
- Work queues, SLAs, and audit-ready documentation
Care Planning & Coordination
- Comprehensive assessments and care plan development
- Goal setting, barrier identification, and intervention planning
- Care team coordination across providers and community resources
- Documentation support and continuity across transitions of care
Our Accreditations
Industry-recognized certifications that demonstrate our commitment to quality, security, and excellence.
Straight from the Source
We’re more than a vendor, we’re a partner. Here’s what our clients have to say:
Sagility invests time to understand our business and develops innovative solutions that would not be possible without their deep operational knowledge.
Payment Integrity Lead,
National Health Plan
They are technology-enabled but prioritize business and partner outcomes above all else. It is not about promoting tools for their own sake — Sagility thoughtfully applies a broad range of capabilities to deliver solutions that drive measurable results. They truly put the client first.
Executive Director, Business Operations,
Healthcare Financial Services Company
The implementation was seamless, and their support team is outstanding. We’ve achieved 98% accuracy in claims processing and reduced our days in A/R from 45 to 28. Their technology is truly game-changing for healthcare providers.
Revenue Cycle Director,
Multi-specialty physician group
Case Studies
See how we’ve helped payers unlock millions in savings and streamline operations:
Insights & Resources
Stay informed with the latest thinking on healthcare payer operations:
Ready to Work Smarter with Sagility?
Let’s explore innovative solutions tailored to your needs—and get more done, together.