In a time of unprecedented transformation in the healthcare industry, staying informed and inspired is not just a benefit — it’s a necessity. That’s why Elligint Health is proud to bring you Sparking Change, our monthly e-newsletter designed especially for our clients and partners. More than just an update, Sparking Change is your strategic companion — offering insights into innovation, performance, and the people driving progress across healthcare.
Exciting Enhancements Coming to Utilization Management in October
Helios UM 3.0 adds enriched functionality designed to streamline UM workflows
Elligint Health is pleased to announce a major update to our Utilization Management (UM) platform — UM 3.0 — designed to make your workflows faster, smarter, and more intuitive. These enhancements come from client feedback and our dedication to delivering tools that improve efficiency and enable better decision-making.
Helios UM 3.0 puts essential tools and insights at your fingertips to accelerate care delivery, support smarter decisions, and streamline utilization management across your organization. An intuitive interface and quick-assignment features make form navigation fast and seamless, while real-time dashboards give the entire care team a clear view of authorizations, grievances, and appeals. An incorporated index let users instantly go to any section of a form, and collapsible sections, customizable filters, and floating context panels deliver the right data without interrupting workflows. Personalized features — like custom queues, saved filters, and watcher functionality — allow every user to tailor their experience and focus on high-priority tasks.
What’s New in UM 3.0?
UM 3.0 introduces several features built around four core pillars:
Faster, More Intuitive Navigation – Access UM functions directly from the top navigation bar, with role-based side tabs for quick entry to forms and functionality. A new “Table of Contents” feature allows instant jumps to any section of a form, while “Quick Assignment” lets you reassign multiple forms — or assign forms to yourself — with a single click.
Focused Workflows – Collapsible sections hide non-essential details until needed, reducing visual clutter. Enhanced filters (“Filters 2.0”) make it easy to create, save, and reuse personalized filter sets and reduce repetitive tasks, while a new “Queues” utility ensures that you go directly to “My Queue” and enables custom queue creation to prioritize tasks.
Access Context Without Losing Your Place – In-screen previews allow you to view member data in a side panel without navigating away from your current form. Line-level, side-panel views enable editing of services, stays, and medications in a floating panel while working elsewhere in the form.
Tailored Views – “Watcher” functionality allows you to track forms of interest—even if you’re not the owner—ensuring you stay informed through real-time notifications.
Timeline for Launch
During October and November, Elligint Health’s Client Services Team will coordinate with clients to roll out UM 3.0 to the UAT environment initially — giving users an opportunity to explore the updated look and feel of the changes — and then to the Production environment. To help clients get the most out of these new features, we will also be offering training that walks through the new functionality.
We are excited to bring these enhancements to you and believe UM 3.0 will make utilization management more streamlined, flexible, and effective for your organization. Stay tuned for more updates as we approach the launch date.
Elligint Health CMO to Speak at Becker’s Healthcare Fall Payer Issues Roundtable Conference
Brian Steele, DO, Chief Medical Officer (CMO) for Elligint Health and member of our Strategic Advisory Board, will be a featured panelist at Becker’s Healthcare Fall Payer Issues Roundtable Conference.
Dr. Steele will participate in a session titled “The Chief Medical Officer’s Role in Shaping Future Strategies” on Monday, November 3, 2025, from 8:00–8:40 a.m. He notes that the CMO role has transformed dramatically over the past 10 to 15 years. No longer just clinical stewards, today’s CMOs act as strategic translators — connecting clinical, business, and technology teams to align priorities across the healthcare ecosystem.
Dr. Steele will be joined by three other panelists who will bring their own perspectives to the discussion:
• Faris Ahmad, MD, FACOG, MBA, Senior Medical Director and Associate CMO, Physician Success and Network Optimization, Blue Cross Blue Shield of Michigan
• Krystal Revai, MD, MPH, CHIE, Associate CMO, Health Alliance Medical Plans
• Roseleen Charania, MD, Associate CMO, Oncology Programs, EviCore by Evernorth
The conference, taking place November 3–5, 2025, in Chicago, will bring together top leaders from health plans and health systems to discuss the future of care delivery.
To learn more about the conference, please go to: https://conferences.beckershospitalreview.com/fall-2025-payer-roundtable
Partner Focus: Helios® + Itiliti Health — Redefining Prior Authorization
Driving efficiency and compliance while reducing costs across the prior authorization life cycle
What’s better than Helios for UM? Helios + Itiliti Health!
Our partnership with Itiliti Health, announced in 2024, brings a powerful enhancement to the Helios platform. Together, we’re helping clients simplify utilization management (UM) and prior authorization (PA), while keeping pace with evolving CMS and state requirements. The result: improved efficiency, lower costs, and better care delivery.
Why It Matters
PA has long been one of the most complex and costly administrative processes in healthcare. Manual steps slow down care, frustrate providers, and add unnecessary expense. While Helios UM streamlines submission, tracking, and reporting of initial and ongoing PAs, re-authorizations, reviews, grievances, and appeals using configurable workflows and CMS-0057-F–mandated FHIR APIs, Helios + Itiliti Health take PAs to the next level. Our combined solution streamlines automation, boosts interoperability, guides decisions with evidence-based support, and clearly communicates payer rules to drive faster, smarter care.
What Clients Gain
By integrating Itiliti Health with Helios, payers can:
• Automate and accelerate PA requests, cutting days off turnaround times
• Improve provider and member satisfaction by reducing friction in the care journey
• Ensure compliance with CMS-0057-F and other regulatory timelines
• Realize significant ROI with measurable reductions in administrative and clinical costs
Clients can adopt this combined solution at any point in their contract and immediately benefit from industry-leading capabilities such as:
• Rules engines that drive enterprise-wide efficiency
• Clinically vetted UM and CM workflows out of the box
• Seamless integrations with fax, EHR, and provider systems
• Integration with InterQual and MCG guidelines for evidence-based decision support
Itiliti Health in Action
Itiliti Health’s suite of products — like PA Checkpoint™, Policy Transparency, PA Routing, Policy Management, Automatic Authorization Rules, and Clinical Decision Assistant — provides an experience that’s fast, accurate, and highly configurable. Care teams gain efficiency, patients receive timely access to care, and disputes and unnecessary submissions are virtually eliminated.
The Bottom Line
Clients who implement Helios + Itiliti Health can expect
• Millions in annual administrative savings
• Over 90% gains in care team efficiency
• Faster closure of critical care gaps
• 80% quicker bidirectional data delivery
Helios and Itiliti Health are proving that automation, transparency, and smart design that can transform PA into a process that works for everyone.
To explore how this solution can benefit your organization, contact your Account Manager today.
Elligint Health Welcomes Medical Associates Health Plans as New Partner
Elligint Health is proud to welcome Medical Associates Health Plans as they take the next step in modernizing their technology infrastructure. By consolidating care management and utilization management (CM/UM) functions into a single, configurable platform, Medical Associates will gain an integrated view of their members’ needs — empowering care teams to deliver more coordinated, value-based care.
Headquartered in Dubuque, Iowa, and founded in 1982 by Medical Associates Clinic, Medical Associates Health Plans was the first health maintenance organization in the Tri-State area. For more than 40 years, they have served employers and residents with comprehensive health insurance products and a distinctive Medicare program. Through their affiliate, Health Choices, they also provide administrative services for self-funded employer health plans.
“Adopting Helios will allow us to modernize our operations, meet evolving CMS regulatory requirements, NCQA accreditation and empower our teams with tools that improve care coordination, member engagement, and overall efficiency.”
— Barb Koerperich, Director of Clinical, Quality and Member Experience from 9/11/2025 Press Release
Welcome, Medical Associates Health Plans — we’re excited to help build a more sustainable model for care delivery that benefits patients and care teams alike.
For more information about Elligint Health, contact your Account Manager today.