Our team provides a range of clinically-focused solutions to health and human services agencies and organizations, helping them reach their program goals of providing the appropriate care for the populations they serve.

We specialize in designing, delivering, and evaluating clinical programming with a special focus in the areas of pharmacy, long-term services and supports, disability determination and medical review, managed care technical assistance, and laboratory testing. Our team of experts includes clinicians, pharmacists, and technical experts.

Learn more about the solutions we deliver:

Clinical Operations and Support Services

• Complex Case Management
• Managed Long-Term Services and Supports Advisory Services
• Medical & Pharmacy Prior Authorization
• Newborn Screening
• Justice-involved Populations
• Pediatric Care Coordination

Clinical Pharmacy Services

• Plan Design
  • Drug Formulary and Prior Authorization Criteria
  • Clinical Rx Management
  • Pipeline Tracking and Budget Impact Forecasting
• Clinical Operations and Support
  • Prior Authorization
  • Medication Adherence
  • Medication Reconciliation
  • Value-Based Arrangements
  • Infection Control and Prevention Advisory Service
• Fiscal Integrity
  • Program Integrity
  • Rebate Management
• Opioid Management

Clinical Eligibility Determination 

• Disability Evaluation
• Preadmission Screening & Resident Review (PASRR)
• Utilization Management
• Home and Community-based Services Waivers

Third Party Administration

• Provider Network Development
• Program Integrity