Member Engagement
As part of Clinical Edge (formerly Wellframe), the member engagement module helps health plans manage rising cost and regulatory complexity with digital, member-first engagement that improves experience, adherence, and outcomes.
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Extend Care Managers reach to members across the risk pyramid
Digital Care Management transforms how care teams address complex needs of high-risk members through a mobile-first app or web-based experience across chronic care, behavioral health, and maternal health.
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70+ curated care programs
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On demand Health Education Library
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Digital Assessments: HRAs, PHQ-9, SDOH
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Secure HIPAA Compliant Chat
Proven Clinical Foundation
Care programs and assessments draw on trusted clinical evidence so care teams can act with confidence and healthplans can support better outcomes.
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Evidence-based guidelines
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Quality measure alignment (HEDIS and STAR)
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Clinically validated assessments
Foster meaningful connections for members across all risk levels.
Care
Management
Identify emerging needs early and deliver timely digital interventions before rising-risk members escalate to high-cost care.
Utilization
Management
Clinically sound, workflow-driven tools with intelligent automation optimize the authorization lifecycle and support compliance.
Appeals
and Grievances
An intuitive, end-to-end solution consolidates appeals, supports regulatory compliance, and delivers one-click packet creation.
Authorization
Portal
End-to-end workflows, automated approvals, and real-time provider communications boost operational agility across your plan.
Mobile
Clinician
Secure mobile access lets field staff run assessments, build care plans, capture consent, and start referrals online or offline.
Member
Engagement
A scalable digital platform pairs omnichannel communication with advanced tools to deliver measurable health outcomes.
Population
Health
Real-time analytics and effective stratification identify at-risk populations and help your teams close care gaps faster.
Quality360
NCQA-certified quality management links HEDIS gap identification to care workflows, streamlining closure and reducing manual work.
Business Intelligence
Advanced reporting and dashboards for CMS and NCQA give your teams the insight to drive smarter, data-backed decisions.
Clinical Edge
University
24/7 access to module-based training, so staff can build product expertise on their own schedule, from anywhere.
$1,923 average savings per member
Health plans leveraging member engagement see an average $1,923 in savings per member, a 9% drop in ER visits, a 17% reduction in inpatient admissions, and a 200% increase in clinician caseload capacity.