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Health Plan Business Process Outsourced (BPO) Services

From full end-to-end support to support for individual capabilities, Synovia Health can help health systems and health plans launch and operate Medicare Advantage plans to ensure they achieve high-performance.

Naya will perform Health Plan services for you while we help you build or improve the capabilities you need.

  • New Plan Startup – Insurance filings and applications; financial structuring; including, capital requirements and RBC development, and development of funding sources.

  • Plan Launch – Application and bid submission process, network development, product development and pricing, systems platform configuration, agent licensing and commissions, go-to-market planning, and marketing and sales plan development and execution.

  • Ongoing Plan Operations – Naya Advisory’s Synovia Health division provides end-to-end support for all functions and processes necessary to operate a high-performing health plan-- front-, mid-, and back-office.  From standard transaction processing functions like enrollment and billing, claim processing, print fulfillment, and customer service; to more complex functions including network development and performance management, medical management and population health; and risk adjustment, 5-star quality, and compliance for Medicare Advantage plans.  Synovia Health provides the services you need to ensure success during the challenges of early plan startup and to control costs as your plan grows.

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HEALTH PLAN OPERATIONS

From Pre-Launch to Day-To-Day Support

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MEMBER HEALTH MANAGEMENT

Improving Health Outcomes

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REVENUE MANAGEMENT

Risk Adjustment and Reimbursement

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PLAN QUALITY & 5 STAR

Plan Performance Management

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NETWORK DEVELOPMENT & COLLABORATION

Building Strong Provider Partnerships

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RISK MANAGEMENT

Regulatory Compliance, Monitoring & Auditing

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TECHNOLOGY PLATFORM

Leading Edge Health Ecosystem Supporting BPO Services

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