Health Plans

The reality of a shifting marketplace demands solutions that are as adaptable and integrated as they are functional. That is why Citra aims to provide a future-proof technology to our customers, thereby ensuring they retain the edge they need to stay competitive and effective. Our technology enables commercial and private health plans to remain flexible while providing quality customer service and reducing overall risk. Both highly customizable and accurate, our standard integrations are configured in a way that allows organizations to rapidly incorporate all systems.

• Grow into complex processes involving benefit plans, provider contracts, and member populations
• Manage value-based care and varied benefit management requirements
• Support comprehensive data needs through collection of provider and member profiles, health plan benefit data, primary care encounters, specialists, authorizations, physician and hospital FFS claims, risk-sharing arrangements, and industry standard codes required for end-to-end UM, QM and claims processing
• Close gaps in care
• Identify high care utilizers, such as CHF, COPD, ER and other high-cost cohorts
• Optimize GPRO reporting at the end of the year
• Manage patients transitioning through care settings

Citra's core technology platform and advanced population health analytics enable Health Plans to fully manage Medicare Advantage, Medi-Cal, Medicaid, FFS, PACE and Carve-Out populations, ensuring you succeed in effectively managing your member population.