PURPOSE BUILT FOR HEALTH PLANS

Expert-Led Strategy. Real-World Execution.

We help health plans and TPAs overcome operational challenges, modernize platforms, and improve outcomes—through healthcare-only expertise and execution.

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Advantages of Working With Impresiv

Deep Understanding of Health Plan Operations

Impresiv brings expertise in:

  • Medical Management (UM, CM, BH, Appeals & Grievances)
  • Claims & Configuration (Facets, QNXT, HealthEdge, etc.)
  • Medicare, Medicaid & D-SNP Compliance
  • Stars, HEDIS, and CAHPS Optimization

We know how a health plan runs day-to-day—and where the friction lies.

Platform-Specific Expertise That Saves Time

Impresiv offers hands-on knowledge of platforms your clients already use, such as:

  • Jiva, TruCare, GuidingCare, Essette (UM/CM)
  • Facets, QNXT, HealthEdge (Core Admin/Claims)

This lets us accelerate discovery, avoid vendor missteps, and optimize configurations immediately.

Experience with Regional & Government Plans

Unlike firms focused solely on national carriers, we specialize in regional plans, startup MAOs, and public sector MCOs that face:

  • Lean internal resources
  • Complex compliance environments
  • Rapid regulatory shifts
  • Greater pressure to prove ROI on spend

We help these clients do more with less—without compromising compliance or outcomes.

WHAT WE DO

Regulatory & Compliance Readiness
  • NCQA & CMS Readiness
  • Medicaid Redesign & Waiver Compliance
  • Duals Integration & D-SNP Strategy
  • Quality Improvement Strategy (Stars, HEDIS, CAHPS)
Technology & Platform Optimization
  • System Selection, Configuration, and Implementation Support
  • Platform Assessments (e.g., Jiva, TruCare, GuidingCare)
  • Data Governance & Interoperability Strategy
  • EHR, Core Admin & Claims Systems Optimization
Operational Strategy & Optimization
  • Care Management & Utilization Management Redesign
  • Prior Authorization Efficiency
  • Clinical Model Transformation
  • Appeals & Grievances Process Improvement
Healthcare Workforce Strategy
  • Staffing Needs Assessment & Gap Analysis
  • Clinical Model Support (In-Home, Virtual, or Hybrid)
  • Organizational Redesign & Change Management
  • Transition Planning & Interim Leadership
Medical Management Transformation
  • UM & CM Platform Optimization (Jiva, TruCare, Essette, CareProminence)
  • Clinical Policy & Workflow Redesign
  • RN, BH, Social Work Integration Models
  • NCQA Readiness & Accreditation Support
  • Complex Case Management Strategy
Get In Touch

Tell us a bit about your organization and what you're looking to solve.

If you have any questions, feel free to contact us 1.888.208.6753

Whether you need help with medical management transformation, claims optimization, or regulatory readiness—we’re here to help.

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