Carenet Health

Last updated
Carenet Health
Company type Private
IndustryBusiness Process Outsourcing, Healthcare Support Services, Medical Call Center, Care Management, Customer Support Services
PredecessorCarenet Healthcare Services
Founded1988 (1988)
FounderJohn Erwin
Headquarters San Antonio, Texas, U.S.
Area served
United States
Key people
John Erwin President
Website carenethealth.com

Carenet Health is US-based advanced healthcare business services organization. With leading-edge technology and unmatched insights driven by rich engagement data and deep industry relationships, Carenet addresses the most challenging population healthcare needs while meeting their clients' business objectives.

Contents

Carenet helps leading healthcare organizations simplify and power the business of healthcare through personalization, innovation and consultation. The company fuels growth for its clients while driving efficiency and seamlessly improving care.

The company's AI-assisted CX solutions innovate in five core areas:

1. ENGAGEMENT: The organization's Intelligent Engagement™ Enterprise leverages their expert talent orchestrated with modern, cloud-based technology to support consumers’ choice, convenience and control when managing appointments and other key interactions. They connect the right people at the right time and place to activate personalized interactions, so patients and members feel seen and heard.

2. CLINICAL SUPPORT: The company provide best-in-class clinical staff members who deliver care across all channels including remote patient monitoring, nurse navigation and health coaching. 24/7, flexible infrastructure provides scalable support to ease the workload of client's internal resources.

3. TELEHEALTH: Their virtual Nurse Triage Center and Nurse Advice Line provide 24/7 nurse navigation and symptom triage to divert unnecessary emergency department/urgent care visits, which helps clients save more while helping patients identify the correct level of care for their needs at the right time and place.These services also provide behavioral health crisis support.

4. ADVOCACY & NAVIGATION: Carenet's advocacy services support commercial clients and their employees. While serving differing populations offering 24/7 access to care for employees to connect with an advocate regarding medical and dental needs

5. CX ANALYTICS: The company's AI-powered CX Analytics Group provides a holistic view of the consumer’s healthcare journey while predicting the next best action to improve customer experiences. The team supports their clients in defining the best customer service journey – identifying where communication breaks down between the business and their consumers to reduce friction points and enable exponential efficiency.

Carenet's clients include 500 premier healthcare organizations including leading health systems, health plans, healthcare services organizations, employer groups, and government-sponsored programs such as Medicare and Medicaid.

Carenet’s team of registered nurses and healthcare professionals has served healthcare consumers in the United States, Europe, Asia and Africa.

The company is headquartered in San Antonio, Texas.

History

Carenet began in 1988 as a patient-management operation within the Christus Santa Rosa Health System in San Antonio, Texas. In 2004, an investor group purchased Carenet from Christus and transitioned the company into a nationwide business processing outsourcer offering medical contact center services that support member and patient programs for healthcare organizations including health plans, hospital systems, employer groups, pharmacy benefit managers, utilization management firms, the US Military, and government-sponsored programs such as Medicare and Medicaid.

Carenet’s initial product offering was a patient navigation and advocacy platform. In 2009 and 2010, Inc. named Carenet Health on their list of 500 Fastest Growing Company in America. [1] [2] The company was also listed on Inc.'s list of 5000 Fastest Growing Company in America from 2011 to 2015. [3] [4] [5] [6] [7]

In 2011, Carenet expanded its services to Europe, Asia and Africa.

Operations

Carenet is headquartered in San Antonio, Texas. The company’s workforce consists of more than two thousand employees located across the United States, Philippines and Trinidad & Tobago.

Services

Carenet provides healthcare support services, healthcare navigation services, care management programs and consumer engagement solutions such as patient advocacy, care navigation, nurse advice line, virtual doctor consultations, medical decision support, hospital post-discharge management, emergency room diversion, disease/condition management, HEDIS and Star rating support, and medication adherence support.[ citation needed ]

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References

  1. "Inc. 5000 2009: The Complete Rankings". www.inc.com. Retrieved 2020-05-15.
  2. "Inc. 5000 2010: The Complete Rankings". www.inc.com. Retrieved 2020-05-15.
  3. "Inc. 5000 2011: The Complete Rankings". www.inc.com. Retrieved 2020-05-15.
  4. "Inc. 5000 2012: The Complete Rankings". www.inc.com. Retrieved 2020-05-15.
  5. "Carenet Ranked a 2013 Inc. 5000 Fastest Growing Company". Archived from the original on 2014-10-25. Retrieved 2014-10-25.
  6. "Carenet Ranked a 2014 Inc. 5000 Fastest Growing Company". Archived from the original on 2014-10-25. Retrieved 2014-10-25.
  7. "Carenet Ranked a 2015 Inc. 5000 Fastest Growing Company". Archived from the original on 2016-02-13. Retrieved 2015-08-27.