Health Plan & Payer Solutions Designed To Reduce Costs & Improve Member Health

Whether you’re leading a Medicaid, Medicare, Exchange, or commercial health plan, the Envolve family of companies will help you analyze the needs of your members, so you can provide quality, cost-effective care that’s right for them.

Why Partner With Envolve?

We’ll help you meet your financial and health outcome goals by providing tailored strategies, support, and flexible benefit management solutions to your organization. Envolve, through our family of companies, offers the following featured solutions for health plans & payers ensuring members get the best care possible:

Our specialty pharmacy provides care management services that focus on members with complex conditions, bringing a personal touch to specialty drug management. We understand that when patients and physicians have the proper resources to create and follow a unique treatment plan, health outcomes improve and costs go down. That’s why our specialty pharmacy program includes:

  • Integrated pharmacy and medical specialty drug management, including claims processing, utilization management, prior authorization, retail, and 340B networks
  • State-of-the-art technology and analytics, including real-time data analysis and reporting
  • IV and injectable drug therapy training
  • The 9th largest specialty pharmacy network in the U.S.
  • Proven medication adherence programs, including monitoring and support
  • URAC Specialty Pharmacy Accreditation

Learn more about why so many trust the Specialty Pharmacy solutions offered by Envolve.

Learn more about Envolve Vision solutions.

Learn more about Envolve Dental solutions.

Our healthcare management services organization (MSO) solutions enable better, more efficient healthcare through best-in-class business administration services, data utilization, clinical excellence, and operational support. Just a few highlights of our services include:

  • Innovative benefit designs to improve member health and comply with state/federal laws
  • A claims processing/payment engine providing accurate adjudication for complex plans and multiple reimbursement models
  • Two datacenters to secure core applications and data with redundant networking systems and backups
  • Production applications backed up daily to off-site storage facility that complies with HIPAA and HITECH rules

Learn more about our MSO Solutions.

Contact Us

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For Member Services and assistance, please contact the telephone number on the back of your Member ID card.

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