NAVIQFLEX

Owner

Goods & Services

Managed care program design and oversight for self-funded employer health benefit plans, namely, developing voluntary care coordination frameworks with tiered benefit levels directing members toward value-based care arrangements prior to the delivery of non-emergency medical services; Healthcare program management services for self-funded health benefit plans, namely, designing and overseeing coordination of medical, behavioral health, and specialty care through voluntary care navigation pathways and developing program documentation for managed care programs; Healthcare navigation program development for self-funded health benefit plan members, namely, designing incentive-based systems that direct members to high-performance provider networks and value-based care arrangements, with enhanced benefits available for members who engage coordinated care pathways prior to receiving non-emergency medical services.

Stop-loss insurance underwriting services for self-funded employer health benefit plans incorporating tiered benefit structures that incentivize member use of coordinated care pathways; Development and management of carrier-integrated managed care programs for self-funded employer health benefit plans, namely, structuring program terms, employer participation agreements, vendor requirements, and tiered benefit plan frameworks under a voluntary care coordination model; Organizing and managing access to high-performance provider networks for self-funded health benefit plans offering differentiated benefit levels based on member participation in voluntary care coordination programs.