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Discover the Power of Intelligent Member Navigation

The Softheon approach to help you navigate members toward better choices is unique. We’ve created a system that complements your data and infrastructure investments. We use this to help you understand your membership at a new level and solve for specific, high-impact issues where member choice is involved. Here’s how the navigation framework operates:

The Member Navigation Framework

You can’t force people to make smart decisions about their care, to participate in wellness programs, to take advantage of care management assistance, or utilize more cost-efficient resources. That’s why you provide outreach. This is also where the Softheon approach shines. No standardized risk models or blanket approaches to member choice here. We deploy powerful automated intelligence and augment your standard data with supplemental data such as SDoH indicators. We help you zero in on the members who’d most likely benefit, set a baseline, structure goals, frame engagement tactics and then embark on a test/learn/optimize cycle keenly focused on the business use case you’re working to solve.

Softheon has the capabilities, expertise, and track record to influence member behavior at scale throughout your health plan.

The Engagement Funnel

Our approach helps you easily identify:

  • Which members to target
  • Which channels to use to reach them
  • Which engagement strategies to employ
  • Who will enroll, participate, and stick with various programs
  • How to scale those learnings and impact the maximum number of members

Using advanced analytics and algorithms, our solution measures the causal impact (financial and otherwise) of our recommendations. We do retrospective program analysis against your existing utilization data. from there we use predictive analytics to:

  • Identify the most valuable member segments for outreach
  • Isolate which members are most receptive and most likely to benefit from your different programs
  • Discover new use cases with the highest probability of member and business impact

Our team carries a wealth of experience within the research, clinical, data science, and client success domains. Softheon solutions have been successfully for clients nationwide. Here’s a brief picture of some core deliverables you can expect as part of our process:

  • Baseline program analysis and interpretations of your current state based on identified use cases.
  • Expert guidance throughout the process to help ensure you are set on the right path and stay there.
  • Impactability analysis to determine where your best opportunities for success reside.
  • Continuous optimization insights to help drive activation and engagement within use cases.
  • Member Intervention Surveillance to identify high-impact use cases from your data.
  • The comfort of a proven project governance methodology.

Our solutions keep pace with your organizational demands and resources available. We can partner with you on a single use case or scale across use cases, lines of businesses, and member populations. The solutions offered were created to perform at the scale your organization needs. Some of the things that make this possible are:

  • Goal and progress visualization.
  • Active member engagement funnel analysis and campaign performance.
  • KPI creation based on your data, your trends, and supporting your strategic goals with our lift charts.
  • Inline optimization analysis based on captured learnings to drive sustained program benefit.

We only work with health plans—national, regional, and integrated health systems. Our deep understanding of payer data across all lines of business drives better outcomes for you and your members..  Our experience allows us the ability to rapidly consolidate various client- provided and third-party data sources into a single master member data file so you can make better decisions for improved results.

Solutions by Health Plan Focus Area

Our solutions are tailored for the areas in your organization where member behavior and choice have a high impact on outcomes and financial performance.

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Bring us your use case and we’ll use our solutions to influence your members towards better choices—choices that help improve their lives and your financial performance.

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