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Product SUITE / Delegation Oversight

Smarter oversight for health plans

A modular suite for managing delegates and vendors—built on a unified platform with automation and AI to give you complete visibility, tighter control, and greater confidence in compliance and operations.
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What we solve

Why delegation oversight programs fail

Delegated vendors handle some of the most sensitive and high-impact functions for your health plan. But when oversight is fragmented or inconsistent, it leads to more than just operational inefficiencies, it opens the door to compliance gaps, financial loss, and declining member satisfaction.

Oversight lives in silos

Emails, spreadsheets, and disconnected systems make it hard to track, manage, or validate delegate activities.

No real-time visibility

Without timely insights, issues escalate before anyone notices, costing time, member trust, and resources.

Inconsistent standards

Different reporting standards and cadences, and communication practices make it nearly impossible to enforce uniformity.

Lack of accountability

Without a system to track performance, risks, and tasks vendors operate without clear boundaries or accountability.

Value we bring

From scattered oversight to connected control

We don’t just help you monitor your vendors; we help you take control of your entire delegation program. With our modular oversight suite, you get structure, visibility, and automation where it matters most. Whether you’re evaluating a new delegate, reviewing performance, or preparing for an audit, everything is connected, so nothing slips.

Enterprise-wide visibility

One dashboard shows where every delegate and vendor stands—no more searching across inboxes or spreadsheets.

Less chasing, more resolving

Automated data collection, alerts, and status tracking free your teams from manual follow-ups.

Compliance risk, controlled

Real-time monitoring, validations, and AI-powered audit prep keep you a step ahead of findings.

Operational cost savings

Cut prep time, reduce review cycles, and avoid penalties with a leaner oversight process.

How we solve

Simplify oversight. Minimize risk. Improve control.

Our Delegation Oversight suite is designed to be modular, so you can start with what you need most and expand as your oversight program grows. Built on a secure, unified platform, your teams, vendors, and compliance processes stay in sync.
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Unified across functions

One platform for operations, compliance, audit, and vendor management, no silos, no duplicates.

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Culture of compliance

Oversight that runs every day, not just at audit time, so you’re never caught off guard.

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Single source of truth

Eliminate the chaos of scattered files and unclear ownership with structured, end-to-end oversight.

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Proactive actions

Spot gaps early with built-in rules, validations, and thresholds that flag non-compliance before it escalates.

Why health plans trust Inovaare

Proven across payers for oversight programs

Oversight isn’t just one of the boxes we check, it’s one of the biggest problems we solve. For over 15 years, we’ve helped Medicare, Medicaid, and Commercial plans modernize how they manage vendor risk, enforce accountability, and stay compliant under pressure.

Purpose-built for payers

Designed with CMS, FDR, and regulatory expectations in mind—no retrofitting required.

Part of a connected platform

Extend oversight into Appeals & Grievances, Risk Management, and Compliance, with shared data across modules.

Seamless integration

Works across departments, connects with existing systems, and flexes to fit your internal workflows.

Key features

Designed to reduce payer oversight effort

From delegate onboarding to auditing, every feature in our suite is built with one goal: to help health plans manage oversight with less manual effort and more confidence.

Audit trail and issue tracking

Maintain full compliance and operational visibility with system-logged actions and status updates.

KPI and threshold monitoring

Track delegate performance with custom KPIs, outlier detection, and configurable thresholds.

Collaborative task assignments

Assign oversight tasks across teams with clear ownership, deadlines, and progress tracking.

Engineered for Compliance. Designed for Efficiency.

Power your oversight program with connected capabilities

Whether you’re streamlining workflows, reducing compliance risk, cutting IT complexity, or protecting budgets, our Delegation Oversight suite delivers value where it counts.

A&G management

Effortlessly manage appeals and grievances! Automate workflows, reduce manual effort, and ensure timely resolutions. Improve compliance and operational efficiency while enhancing member satisfaction with seamless, accurate, and real-time tracking of appeals and grievances. ×

Member journey dashboard

Gain Comprehensive Insights into Member Journeys! Track every touchpoint and interaction across the member lifecycle, providing a holistic view that drives better decision-making. Identify trends, improve service delivery, and increase member satisfaction with detailed, actionable insights. ×

PQI & QIO

Ensure the highest standards of quality care with our Potential Quality Issue (PQI) & Quality Information Organization (QIO) solutions. Automate quality improvement processes, monitor performance metrics, and comply with regulatory standards. Drive continuous improvement in care delivery and outcomes, and maintain excellence in healthcare services. ×

Data scrubber suite

Our Data Scrubber Suite helps you maintain clean, accurate data for all your reporting needs. Automate data scrubbing processes to identify and correct errors, ensuring compliance with regulatory requirements. Improve data integrity, reduce risks, and enhance decision-making with reliable data. ×

Operational efficiency

Fewer bottlenecks, smoother vendor coordination

Operations teams get a clear view into every delegate’s status with real-time dashboards, automated task assignments, and built-in workflows. No more chasing documents or relying on email. Our platform simplifies vendor oversight and improves turnaround time across the board, so you can scale oversight without scaling your team.
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Compliance control

From reactive checks to real-time compliance

Compliance leaders get more than audit readiness, they get proactive control. With built-in CMS-aligned templates, real-time validations, automated CAP tracking, and complete audit trails, our platform reduces manual effort and helps ensure your delegate oversight program meets evolving regulatory expectations.

IT simplicity

Modular, secure, and easy to integrate

IT teams appreciate our API-first, cloud-native architecture. No bulky deployments, no fragile custom builds. We integrate with existing systems, offer role-based access controls, and meet HIPAA and HITRUST standards, ensuring your oversight solution is scalable, secure, and support-light.

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Financial protection

Reduce vendor risk and oversight cost

For finance teams, better oversight means better margins. Our clients report fewer penalties, lower rework costs, and faster resolution of delegate issues. By automating repetitive tasks and surfacing issues early, we help you control vendor risk and drive real ROI from your compliance investments.

Success story

How a national Medicare plan modernized its delegate oversight program

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Reduction in oversight effort
0 %
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Faster delegate file reviews
0 %
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Annual operational ROI ($)
0 K
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Faster vendor onboarding
0 X

Key Products

From evaluation to enforcement, built for payer oversight programs

Our Delegation Oversight suite includes four core modules, all built on a unified platform that keeps operations, compliance, and vendors in sync. Each module is designed to reduce effort, close gaps, and keep your vendors and your plan on track.
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Delegate Determination

Evaluate potential delegates using configurable criteria, workflows, and alerts. Ensure only qualified entities move forward, reducing risk from day one.

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Delegate Repository

Centralize all delegate data, documents, and interactions. Secure access, version tracking, and easy retrieval means nothing gets lost or missed.

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DE Audit & Corrective Action

Manage the full audit lifecycle with automated issue logging, CAP workflows, and universe scrubbers. Monitor progress in real time and stay CMS-ready.

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Reporting & Monitoring

Track KPIs, monitor file submissions, and identify outliers. Built-in templates, validations, and dashboards simplify ongoing compliance monitoring.

FAQs

Have questions? We have answers.

Regulatory Compliance

Does this support CMS audit readiness?
Yes. Our system includes CMS-aligned templates, scrubbers, audit trails, and CAP tracking to ensure you’re always prepared—proactively, not reactively.
Can we configure compliance rules to match our internal standards?
Absolutely. You can create custom rules, triggers, and workflows that align with your plan’s policies while staying CMS-compliant.
How does the system help us stay compliant year-round?
By automating data validations, monitoring KPIs, and providing real-time alerts, the system ensures you catch issues early—not at audit time.

Pricing & Implementation

Is Delegation Oversight suite sold as a full suite or by module?
It’s modular. You can start with one or two components and expand as needed.
What’s the typical implementation timeline?
Most plans go live in 4–8 weeks, depending on scope and data complexity.
What kind of support do we get during rollout?
You get a dedicated implementation team, onboarding workshops, and post-launch support tailored to your program’s needs.

Operations

Can vendors access the system directly?
Yes. Each delegate gets a secure, role-based portal to submit files, scrub data, and complete assigned tasks.
Can we assign tasks internally across teams?
Definitely. You can assign, track, and escalate tasks across departments with clear ownership and status visibility.
Does it help with performance monitoring?
Yes. You can track custom KPIs, set thresholds, and identify outliers across all vendors to stay ahead of service gaps.

Technology

Is your Delegation Oversight suite secure?
Yes. Our platform is HIPAA-compliant, HITRUST-certified, and hosted on secure, scalable cloud infrastructure built for healthcare data.
How often is the platform updated?
We deliver regular feature and security updates with no disruption to your workflows.
Does Inovaare support no-code or low-code configuration for workflows?
Yes. Our self-service platform empowers users to configure rules, routing, templates, and workflows with no or minimal developer support, reducing IT dependency and increasing agility.
Do you support single sign-on (SSO) and role-based access?
Yes. We support SSO integration and offer granular, role-based access controls across all modules to maintain data security and user governance.
What infrastructure or hosting model does Inovaare follow?
Inovaare is hosted on a secure, scalable cloud-native infrastructure with multi-region backup, automated updates, and 24/7 monitoring. It’s built for performance, reliability, and compliance with industry-leading standards.
Is the solution vailable for on-premise deployment?
No. Our Delegation Oversight suite platform is cloud-native and available only as a SaaS solution. This ensures faster deployment, lower IT overhead, automatic updates, and better scalability—ideal for healthcare organizations looking to modernize without infrastructure burden.

Explore our AI-driven healthcare solutions

Struggling with compliance burdens, operational delays, or data gaps?

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