Member Experience / Health Plan Services CRM
Improve member experience with an intelligent CRM
Manage member interactions with an industry-leading health plan CRM that expedites the resolution process through built-in automation, empowering Member Services teams to drive member loyalty.
Value & Benefits
Increase member loyalty
Leverage powerful tools to deliver exceptional member experiences and transform Member Services by increasing efficiency, enhancing satisfaction, ensuring compliance, and optimizing resources. Â
Enhanced member satisfaction and an optimized Member Services workforce
Member satisfaction
Compliance breaches
Operational costs
Team productivity
Seamless integration with your existing systems to efficiently manage member relationships.
Centralized incoming
queue
Unified management of web, fax, and email inquiries for consistent member engagement
Integrated genAI
copilot
Personalize communication for preferred channels using advanced AI capabilities.
Member feedback
integration
Collect and analyze member feedback to continuously improve services and satisfaction.
Targeted care
delivery
Segment members to provide a personalized care plan.
Key features
Complete member interaction visibility at your fingertips
Gain a comprehensive view of every member interaction for personalized and effective support.Â
Optimized Productivity
Maximize efficiency, minimize effort
Use our streamlined 2-step case closure process to boost productivity and reduce resolution times.
Smart Interactions
AI-driven precision in every interaction
Leverage intelligent guidance to achieve quicker, more impactful resolutions and enhance member satisfaction.
Workflow Management Tools
Optimize your team’s performance
Efficiently manage resources and enhance team productivity with our integrated workforce management tools.
Personalization
Hyper-personalized case management
Customize each case to the individual member’s needs until successful completion, ensuring satisfaction and loyalty.
Related products
Enable additional capabilities
Member Experience
Health Plan Marketing CRM
Member Experience
Member360
Unify fragmented data into a 360-degree view of your members, enabling smarter decision-making and streamlined operations.Â
Member Experience
Member Portal
Provide members with a secure portal with 24/7 access to health information, benefits, and service requests, to boost member satisfaction and engagement.Â
Member Experience
Call Log Scrubber
Scrub CRM data to identify cases that need to be expedited and transferred to the health plan’s Appeals and Grievances Department.
Member Experience
A&G Management
Streamline and automate the handling of member grievances and appeals, ensuring quick and compliant resolutions that boost member trust and loyalty.
Member Experience
Potential Quality Issues (PQI)
Stop reacting and start leading. Equip your health plan with the tools to proactively identify, manage, and resolve quality issues before they escalate.
Member Experience
A&G Universe Generator
Automate the formatting of appeal and grievance universes with a single click, saving time and reducing manual errors.