TriZetto's Business Performance Consultants can help you make measurable improvements in your business processes, help you prepare for new product-to-market strategies and grow your data management structure and reports to drive intelligent business decisions.
Consumer Retail Readiness
As user adoption of consumer retail healthcare solutions grows, health plans are building an integrated consumer retail healthcare solution that will meet short and long-term needs. TriZetto's Retail Readiness Services help deliver a profitable and an integrated consumer retail healthcare solution to the market faster, including planning for and integrating fund management, consumer web solutions, decision support tools, health content and care tools, and point of service solutions.
InfoTrust® Risk Analysis
From understanding how to design health plans to minimize risk to investigating and mitigating fraud and abuse, risk assessment is a critical component of any healthcare operation. TriZetto’s InfoTrust Risk Analysis services help health plans identify and resolve high risk. Specific capabilities include: health plan claim liability projections and management, benefit plan design based on diagnostic level predictive models, claims ratio “cluster analysis” (high utilization or inefficient networks), preventative maintenance and disease management program efficiency with case management review, clinical intervention monitoring and result measurement, fraud and abuse identification and mitigation.
Provider Cost & Quality of Care
As health plans look to improve the cost and quality of care, automating provider network management activities is critical to reducing costs. TriZetto's Network Management Consulting Services will help you meet regulatory compliance requirements—including NPI readiness—assess your ability to enter new markets, recruit physicians, optimize your network management and contract processes and prepare for pay-for-quality programs. Integrated with TriZetto's Network Management applications, these services enable your healthcare organization to focus on managing and improving the quality and cost effectiveness of your provider network, while addressing the administrative costs inherent in these processes.
Business Cycle Improvement
Imagine adding new businesses or services with less stress on your IT Department or improving productivity by maximizing your current investments. TriZetto's Business Cycle Improvement (BCI) services help you leverage your people, processes and technology to maximize system upgrades, add new business lines, or remove duplicative processes. The result is stronger business and technology performance that impacts your top line initiatives and your bottom line results.
Business Intelligence and Reporting Services
Facets maintains data about your members, providers and administrative processes. To aggregate the data you need to drive your business, from identifying operational deficiencies to projecting strategic trends, you need to consolidate all of your corporate data into a single, easy-to-use source. TriZetto's Business Intelligence Services help you build a data architecture and practical health plan reports that deliver key information to the business owners who drive operational decisions.
Government Consulting Services
As the government continues to enhance the Medicare Advantage, Medicare Part D and Medicaid programs, your ability to grow your Government business relies not just on the technology but on the business processes you use to support your technology. TriZetto's Government Consulting Services help you assess new markets, assist with your CMS and state specific application process, identify care management opportunities and areas to improve medical cost and quality, build the business workflows that will drive administrative efficiency in your Government business, perform claim risk modeling to maximize reimbursement, roll out your Government program to enhance revenue growth, and develop the Government-specific reports to measure your success.
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