Pharmacy Benefit Management

Carelon is a healthcare services company that brings together clinical expertise, technology, and connected services to help make care more integrated, personalized, and sustainable. It serves healthcare payers, employers, governments, care providers, and life sciences companies, offering capabilities across pharmacy, behavioral health, medical benefits management, research, and healthcare operations.

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analyticsbehavioral health servicesbusiness process automationcare navigationclaims processingclinical reviewcloud adoptionutilization management

Evolent specializes in connecting care for people with complex conditions, working across specialties and primary care to improve the care journey for patients with cancer, cardiovascular diseases, musculoskeletal disorders, and other conditions. Its solutions span multiple medical specialties, offering health plans the potential to improve health outcomes and affordability across the member experience.

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actuarial servicesbehavioral healthcare managementclaims processingclinical pathwayscontact center servicesData managementdecision supportencounters managementenrollment and eligibilitymedical economics analyticsMSO for delegated provider servicespopulation health managementprovider credentialingprovider/patient engagementrisk adjustment and quality