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Managed Care Organisations

Caredirector For Managed Care Organizations

CareDirector provides an intuitive, flexible software solution for Managed Care Organizations who support our most vulnerable populations, and includes secure portal access for providers and members.  CareDirector helps case managers manage referrals, assess needs and options, create service plans linked to authorizations; helps agencies budget and coordinate services, and streamlines financial and service data collection and management for claims, reimbursement and reporting purposes. CareDirector is flexible and interoperable, enabling organizations to manage a wide range of clinical and business areas from one central platform, eliminating silos and the need for multiple systems.


The consumer portal enables client self-service, empowering members to find approved providers, participate more fully in their own care, and communicate online with their team, resulting in a reduced paperwork and administrative burden.

CareDirector helps Managed Care Organizations to manage their provider network, maintaining a comprehensive record of provider information, including locations, hours, languages, programs, staff, and approved services and rates. With the provider portal,  providers may apply online, and (when approved) manage referrals, applications, agency information, view authorizations and record services securely through the portal.

The Resource Search feature helps care managers find approved providers meeting member needs, including Levels of Care, and acuity considerations. The resulting service authorizations tightly link the provider, the care plan and the service; dates, dollars and units. CareDirector supports HIPAA compliant eligibility, claims and reimbursement transactions, facilitating communication with providers, payers, TPAs and state systems.

Features of CareDirector’s Managed Care Organizations Solution include:

  • Member Management – Liabilities, Level of care, Medications, Activities of Daily Living, Vital Signs and Metrics
  • Staff members- Access into interactive dashboards containing critical information, deadlines, tasks and job specifications
  • Integration with State systems – Eligibility and Medicaid
  • Financial Staff- Access to a full suite of reports, including capitation and IBNR
  • Complex service authorizations – Pharmacy, DME, DMS
  • HIPAA Transactions
  • Integration with TPAs and Providers
  • Portals for Members and Providers – Provide visibility into member, provider and financial management