Health Plan

Health Plans

People, process and technology working together to achieve success

New regulatory requirements impacts the way our clients are doing business, and we are their go-to resource to navigate this changing healthcare landscape with confidence.

We thrive in the trenches

Our clients look to us first to help with strategy, operational analysis, regulatory compliance, quality programs, technical evaluation and project management.

Through a strong health plan network, FluidEdge has access to a large number of health plan-focused resources with knowledge of many core claims processing systems. Additionally, FluidEdge has key knowledge of provider data management systems and care/medical management systems

We can help you with:

  • Enterprise Strategy and Solutions
  • Third Party Administration
  • Business Process Outsourcing
  • Project Management Office

Specific Services

Interoperability & FHIR
  • CMS Interoperability & Patient Access Rule
  • Consulting & Training
  • Technology Development
  • Vendor Selection & Implementation
  • Turnkey Solutions / Cloud Platform
Claims Systems Consulting
  • Trizetto (Facets, QNXT)
  • HealthEdge (HealthRules)
  • Ram Technologies
Operational Services
  • Assessment & Strategy
  • Workflow Redesign
  • Process Re-engineering
  • Claims, Benefits, Enrollment
  • Process Improvement
  • Managed Care Product Development
  • Customer Service Optimization
  • Organization, Process & System Assessments and Strategy
Human Capital
  • Interim Executive-level Management
  • Program and Project Management
  • Technical and Business Staff Augmentation
Operations Support
  • Claims Audit, Analysis and Recovery
  • Benefit, Member and Provider Configuration
  • Medicare, Medicaid, Medi-Cal
  • Medical Management (UM/CM/DM) and Population Health Management
IT Services
  • Data Analytics
  • Application/Technical Architecture
  • System Procurement & Implementation
  • System Implementation & Optimization
  • Methodology Development
  • Testing
  • Training
  • Provider Data Strategies