We bring our platform and data science accelerator assets to the table and rich experience from working with healthcare payers of different types.
Global premier partner with IBM Watson Health (including Truven Health Analytics, Explorys, Phytel)
Dedicated technology practice – with advanced data management and analytics services arm:
Technology capabilities and services to deliver successful engagements in the healthcare domain
5000+ certified data and analytics resources
End-to-end capabilities in modernizing data platforms, analytics and AI/ML, data strategy and consulting, DWBI, data lake + cloud, and data governance
Dedicated consultative and advisory services practice specializing in the healthcare payer domain
Partnered with 9 of the top 10 healthcare payers
Analytics and AI-as-a-Service AI/ML-driven analytics, task routing, business rules-driven integration, intelligent workflow leveraging cognitive analytics, smarter intake leveraging NLP, OCR, and HCR, efficient claims processing using adaptive and predictive AI models, and focused care management based on the propensity of member parameters.
Intelligent visualizations Descriptive, predictive, and prescriptive provider functional and sub-functional reports and dashboards, and member functional and sub-functional reports and dashboards. It also includes operational and strategic shared services reports and dashboards.
Data governance (DG) DG provides orchestration for provider onboarding, claims, membership enrollment, and care management. It also includes master data management, data quality management, data security and privacy management, and data reconciliation platform for members.
Data and process integration Analytics process alignment across business processes and functions, shared services processes and functions, analytics tools, methodologies and capabilities for onboarding, claims, services, enrollment, care management, services, etc.
IBM Watson Health resources Data-sets (MarketScan, Explorys, SpringPulse (SDoH), MarketResearch), and analytics methodologies (Flexible Analytics)
A leading healthcare analytics firm gains 50% improvement in processing time with Virtusa’s claims inventory analytics implementation.
Virtusa partners with a regional healthcare payer to streamline the HEDIS reporting process and drive actionable insights from data.
A regional healthcare payer achieves 94% reduction in manual effort and >60% reduction in report execution time with improved accuracy using Virtusa’s compliance and prompt pay audit.
Virtusa collaborates with a national Blue payer to identify the right level of care for patients by stratifying into risk pools using HL7 CCD data.
Helps strategize and host data lake both on-prem and cloud, cloud data lake implementation (AWS, Snowflake), NoSQL implementation (MongoDB, Cassandra, neo4j), real-time data integration, and execute cloud data migration leveraging HITRUST and HIPAA standards.
Virtusa implements analytics-led root cause identification of appeals and grievances and automated balancing, control, and exception reporting for a national Blue payer.
A regional Blue payer partners with Virtusa to leverage CMS Medicare Datasets for prediction of membership enrollment of a health insurance plan.