CareWorx Healthcare Solutions

Health Plans

Managed Care & Health Plans

We support Managed Care Plans, Dual Special Needs Plans, TPAs, and plan-facing vendors with provider network growth, member engagement campaigns, and the CalAIM execution work that keeps regulators and members satisfied.

Health Plans

Segments we serve

Medi-Cal Managed Care PlansD-SNP and Medicare Advantage plansThird-party administratorsPlan-facing technology vendorsPopulation health and care management partnersQuality and HEDIS improvement partners

Outcomes

What growth looks like in Managed Care & Health Plans.

Concrete shifts our partners see when we own this work end-to-end across health plans.

  1. 01

    Deeper, higher-performing provider networks

  2. 02

    Engaged members who use covered benefits

  3. 03

    CalAIM operational lift with field partners

  4. 04

    Quality and CAHPS-friendly member experience

How we engage

Services we typically deploy here.

Most Managed Care & Health Plans engagements pull from this set — sized to your stage, payer mix, and team capacity.

Provider recruitment and network growth

Member acquisition and engagement

CalAIM growth services with delegated partners

Dashboards and reporting across the network

Common challenges

The problems we solve in Managed Care & Health Plans.

Patterns we see again and again — and how we work through them with operators in this space.

Challenge 01

Provider network gaps in critical specialties and counties keep showing up in regulator reports.

Our approach

Recruitment campaigns scoped by specialty, county, and language that close adequacy gaps with measurable timelines.

Challenge 02

Members don't know what benefits they have, so utilization and quality scores suffer.

Our approach

Plain-language, bilingual member engagement campaigns tied to specific benefits and care gaps.

Challenge 03

Delegated CalAIM partners are inconsistent — some scale ECM/CS, most stall.

Our approach

Standardized partner enablement, co-branded materials, and shared reporting so the network performs as one program.

Health Plans

Ready to grow in Managed Care & Health Plans?

Tell us about your program. We'll come back with a healthcare growth audit specific to your payers, populations, and goals.

Book a Healthcare Growth Audit