Accelerate Smarter Care for Modern Health Plans
A Connected Platform for Intelligent Medical Management
Elligint Health combines three powerful capabilities to help health plans perform with confidence:
Operational Foundation
Helios® by Elligint Health streamlines proactive care management (Helios CM) and utilization management (Helios UM) through configurable workflows and intelligent automation at scale.
Intelligence
Layer
Advanced Analytics by Elligint Health turns data into direction — surfacing risk, quality gaps, and performance insights in real time while delivering performance intelligence across clinical, operational, and financial domains.
AI-Ready Capability Expansion
Built on AI-ready architecture, Helios integrates specialized partner technologies directly into care management and utilization management workflows — enabling organizations to orchestrate AI-enabled clinical decision support, risk forecasting models, and other advanced capabilities.
From Insight to Action — Accelerating Smarter Care in One Platform
- Automate care management and utilization management workflows
- Accelerate prior authorization decision to meet CMS-0057-F timelines
- Identify high-risk members earlier with predictive insights
- Coordinate care across teams and providers in real time
- Maintain audit-ready compliance with CMS-aligned tracking
- Scale across populations without adding operational complexity
This isn’t a patchwork of tools. It’s one connected system built for accountability.
Why Health Plans Trust Elligint Health
Recognized
Performance
Helios® by Elligint Health was rated a top performer by KLAS Research in 2025 — supporting over 13M covered lives.
Real Results,
Proven ROI
Clients using our solutions report significant productivity gains and improved efficiency for care teams.
Built for
What’s Next
Configurable, compliant, and designed to scale with evolving regulatory requirements and care models.
- One platform for care management, utilization management, disease management, and population health management
- Automated workflows that reduce manual work and operational delays
- Faster prior authorizations decisions aligned with CMS-0057F reforms
- Smarter care for populations with complex and chronic care needs
- Proactive identification of high-risk and high-cost members
- Configurable workflows, assessments, and care plan automation
- Built-in regulatory compliance and quality reporting
- Advanced analytics that surface insights across fragmented data sources
Configurable Workflows, Intelligent Care Planning, Assessments & Risk Stratification, Transitions of Care, Chronic Disease Management, Referral Tracking
Quality Measurement & Tracking, Gaps in Care Identification & Closure, HEDIS & CMS Program Support, Performance Optimization
Cost & Utilization Management, Medical Expense Analysis, Value-Based Contract Support, Risk Adjustment Insights, Financial Performance Analytics
Prior Authorization Management, Configurable Routing & Tracking, Grievances & Appeals, Medical Necessity Review, Automated Decision Support
Member Engagement & Outreach, Omni-Channel Communication, Program Enrollment, Adherence Support, SDOH Insights
Provider Collaboration & Alignment, Network Performance Management, Value-Based Program Support, Clinical Data Exchange, Provider Portal
Contract Performance Management, Quality & Cost Alignment, Risk Stratification & Attribution, Provider Performance Insights
Ready to Strengthen Your Medical Management Infrastructure?
Helios® by Elligint Health helps health plans streamline operations, improve regulatory compliance, and deliver better outcomes across complex member populations.