Ready to Master Medicaid? Let's Talk.
Email EHSPartners@evolenthealth.com to discuss how
Evolent Health Services can help meet your Medicaid MCO's unique needs.
EHS-2112393-0901
TURNKEY BUSINESS PROCESS AS A SERVICE SOLUTION SET
Evolent leverages our deep subject matter expertise, administrative scale and global footprint to provide
a comprehensive—or select—set of services based on your needs.
Core Administration
Modern suite of back-office capabilities
and services that drive operational
efficiency through greater automation
for enrollment, claims administration,
appeals and grievances, complaint tracking,
contact center, premium billing, portals,
encounters, payment integrity and FWA.
Clinical Services
A whole-person approach to managing
a member's needs built upon NCQA
accredited care management, population
health and utilization management.
Risk Adjustment & Quality
Our integrated approach to risk adjustment
and quality includes care gap closure,
physician support, HEDIS optimization and
records review paired with an industry-leading
prospective approach to risk adjustment.
Data-Driven Insights
Actionable analytics and reporting serve as an
extension to your organization, and tailored
reporting meets state regulatory requirements.
Compliance Support
An audit-ready organization closely manages
regulatory development and guidance to
ensure compliance for Evolent and our partners.
Provider Engagement
Provider engagement and management
includes provider relations, provider
communications, incentive development
and provider data management
to support your network.
Payment Management
We offer expertise and systematic support
for all payment models, including fee
for service, capitation, incentive, and
value-based payment programs.
Proven Implementation Model
Our mature and proven model focuses on
partner success, transparency, quality and
speed that results in on-time implementations.