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Utilization Management

The most powerful tools to streamline utilization workflows, automate repetitive administrative tasks, and empower users to work collaboratively in support of patient-centric goals.


Our Solution, Your Way

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Our fully integrated and composable design allows you to build the software that meets your needs today, and the flexibility to evolve in the future.

What's Included:

  • UM Control Panel
  • Authorization and Referral Workflows
  • Letters Management
  • Compliance Reporting
  • Care Management Workflow Integration

Add-On Modules:

  • Provider Portal

Watch a Quick Overview

Discover our streamlined utilization workflow tools to automate repetitive administrative tasks, support regulatory compliance, and empower users with member-centric clinical and eligibility information.

Request a Call  Book a Demo

IPA Grows MA & Medicaid Business by 12% with Payment & Utilization Tools

When a West Coast IPA wanted to expand their Medicare and Medicaid business lines, they turned to Cedar Gate. Our advanced claims processing, care management, and utilization management tools helped streamline operational efficiency by automating complex administrative processes and identify care opportunities.

The Enterprise Data Management Difference

What sets us apart? Every client receives access to data tools that integrate virtually any source into a single, unified data lake. We automatically cleanse, normalize, and enrich the information so you get high-quality data warehoused securely in the cloud and accessible from anywhere. It’s the ultimate source of truth to power all activities in a value-based care world.

Client-First Approach

We believe in true partnership to be successful. That’s why we focus on a client-first approach including:

  • Skilled Team to Guide Implementation
  • Dedicated Client Success Manager to Meet Goals
  • Training Team Delivering New Learning Opportunities
  • “Always On” Support Team When Obstacles Arise

More Solutions from Our Complete, Composable Platform

Get the right technology for wherever you are on a value-based care journey. Our composable platform end-to-end capabilities for analytics, population health, and payment technology – and it’s all integrated with our world-class enterprise data management system. Check out solutions other clients use alongside Utilization Management and start building your ideal VBC software today.
Comprehensive predictive and prescriptive analytics to maximize payer and provider performance in alternative payment and care delivery models.
  • Identify and mitigate variations in cost and quality to meet value-based care goals
  • Pinpoint high-performing providers and quality drivers with advanced benchmarking tools
  • Create condition-based patient cohorts to reduce costly omissions or gaps in care
  • Model VBC contracts to ensure you can meet clinical and financial performance goals
  • Share insights with anyone using customizable dashboards and automated reports
A flexible, efficient payment software to manage capitated payments in any value-based care program or line of business.
  • Manage constantly changing eligibility rolls and optimize risk, quality, and cost
  • Easily administer multiple capitated payment agreements with various providers
  • Model risk and identify key performance drivers for clinical and financial success
  • Create automated workflows to streamline authorizations and referrals for accurate claims
  • Maintain oversight with automated checks and balances and advanced reporting tools

Explore the Platform

The right solution for your value-based journey is only a click away. Our modular technology is quickly and easily integrated into current systems and complements existing IT investments so that we can grow with you.

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