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Best Utilization Management Software

Compare the Top Utilization Management Software as of November 2025

What is Utilization Management Software?

Utilization management software is an important tool for helping healthcare providers manage patient care. It can help streamline processes, automate procedures and review treatments to ensure quality and cost-effectiveness. This software also offers features such as pre-authorization requests, clinical criteria checks and concurrent reviews. Finally, utilization management software can help analyze cost savings and outcomes while providing insights into treatment options. Compare and read user reviews of the best Utilization Management software currently available using the table below. This list is updated regularly.

  • 1
    Rallyest

    Rallyest

    Rallyest

    Imagine having a way to support someone in treatment with a mobile secure and user-friendly tool. Wouldn’t it be amazing to have the ability to rally a client’s professional team and their natural network of support to increase the likelihood of lasting treatment success? You can give clients your best with Rallyest. Rallyest is pleased to announce the addition of video capabilities to the must-have line-up of features. By using a smartphone or computer, Rallyest captures secure video to share with a client, their support network, as well as their professionals. Making improved and confidential input, support, and connection possible for those in treatment settings. Engage clients, involve their support network, and boost treatment success for everyone. Rally a client’s extended network of select family, friends, co-workers, clergy, and professionals. Enjoy one location for a client’s photos, videos, updates, files, posts, comments, notifications, announcements, etc.
    Starting Price: Free
  • 2
    Getinge

    Getinge

    Getinge

    The need for integrated solutions and access to knowledge is essential, as technology evolves and therapies become more sophisticated. As your full-service partner, we support you through the entire clinical pathway, so that you can continue to provide excellent care, without ever compromising on quality and safety. Whether you are producing the cures of today or discovering the cures of the future, preventing contamination from occurring is the common challenge. We are there to support you in ensuring a productive and contamination-free research or production environment. Advanced medical equipment needs the combination of smart financial solutions and preventive service maintenance to ensure maximum uptime. We offer you full cost control and peace of mind, allowing you to focus on what's important, saving lives. As a leading medtech company, we focus every talent and resource towards helping our customers save as many lives as possible.
  • 3
    XSOLIS CORTEX
    A new category of utilization management software, CORTEX provides a 360° approach to addressing the intricacies of utilization management and revenue cycle processes. Powered by real-time predictive analytics and machine learning engine, CORTEX ensures that the right cases are handled at the right time, by the right staff or by exception. CORTEX incorporates precision medicine upon a foundation of evidence-based medicine. Machine learning models operate in real-time to better assess your patient population. Our analytics have been deployed in hospitals and health plans across the nation. With clear inpatient cases, CORTEX does the heavy lifting by automating inpatient determinations on cases that meet your unique threshold. For difficult cases, CORTEX offers your staff the insight they need to make a strong determination. This approach offers incredible value to payers and providers alike.
  • 4
    Swoop

    Swoop

    Swoop

    Privacy-safe DTC and HCP segments that are higher in audience quality and drive greater lift over conventional targeting approaches. Every therapy is specialized and each brand is unique so we don’t believe in traditional condition-based segments. We seek to understand your challenges and business goals when designing custom audiences. Whether you are a market leader, a new entrant facing adherence challenges, or planning to execute a multi-product strategy, we can help you drive results. We maintain the industry's highest standard of performance markers as validated by third parties. And if you reveal your Audience Quality (AQ) benchmark upfront, we guarantee to meet or exceed it. Higher AQ drives greater engagement, optimizes conversion, and ultimately increases script lift, as well as boosts therapy adherence and thus patient lifetime value. We ensure 100% compliance with all laws, policies and guidelines.
  • 5
    Icario

    Icario

    Icario

    Connect personally and powerfully with people with the leading digital-first platform. Increase above the national average in annual wellness visits. Icario is a health action company so you only pay for outcomes. Icario uses whole-person data, behavioral science, digital-first omnichannel pathways, and smart rewards and incentives to help you connect personally with people. We know what they want, how they like to connect, and what moves them to take action. When people take proactive steps for better health, healthcare organizations get healthier, too. Icario combines your data with ours to create whole-person data, turning lines on a spreadsheet into living, breathing people. Our proprietary behavioral research and quantitative data advance your knowledge of people from clinical to deeply personal. Smart, omnichannel pathways match the right messages and outreach sequences to each individual to drive the right health actions.
  • 6
    Jembi

    Jembi

    Jembi

    We partner with aid organizations and governments, to design human-centered, open-sourced health information systems. Extracting insights that empower decision-makers, health workers, and patients in Africa. We specialize in digital health information systems for African low-resource settings. We focus on enterprise software and facility hardware. From design to development, then onward to implementation, training, and support. In the future, data analysis for the strategic management of those limited resources. We believe that robust health systems, and the sharing of information, will advance global health. Strengthening our health systems with local people for their own needs. Investing in and developing systems that are within reach of low-income countries. Helping build their capabilities to support their own solutions. We are an African non-profit organization improving global health by developing information systems, partnerships, and local capacity.
  • 7
    Lightbeam

    Lightbeam

    Lightbeam

    Lightbeam provides population health enablement by transforming insights into outcomes. Closing care gaps and minimizing risks. Improving quality of care and quality of life. Lightbeam’s proven population health management platform transforms disparate data into a full 360-degree patient picture, bringing true value to value-based care. In today’s value-based care model, managing risk begins and ends with data intelligence. Lightbeam’s powerful population health management platform pulls patient data together in unprecedented ways, unlocking the value that comes from deploying the right data in the right place at the right time. Lightbeam isn’t just revolutionizing how our clients manage value-based care. It’s proving to be a game changer in driving results and saving our clients over 2 billion dollars since 2014 and we’re just getting started. Lightbeam’s tech-enabled services approach seamlessly supports these efforts.
  • 8
    Envolve MSO Healthcare
    Through valuable partnerships and experience, Envolve drives real healthcare transformation through value-based, affordable care solutions. Envolve MSO services provide organizations with the strategies, people, and processes necessary to provide value-based, affordable care and drive real healthcare transformation. As a leading healthcare management services provider, we bring innovation, experience, and resources to help drive performance in outcomes-focused and value-based reimbursement models. Our healthcare management services allow for better healthcare and efficiency in the delivery of care through best-in-class business administration services, data utilization, clinical excellence, and operational support. Envolve brings significant experience investing in innovative benefit designs for numerous products throughout the country for publicly funded, marketplace, and commercial programs that positively influence individuals' health and quality of life.
  • 9
    Bamboo Health

    Bamboo Health

    Bamboo Health

    With an innovative suite of solutions and the most interoperable care collaboration network, we are realizing a vision of whole-person care that’s shifting expectations and revolutionizing healthcare. Enabling more informed decision-making and better outcomes starts with a promise, a promise to continue listening, collaborating, and disrupting. It’s the heart of our vision and the reason we are able to drive powerful results across all settings of care. Decide on the right care options and act with certainty with real-time insight and the largest care collaboration network in the nation. Quickly identify the optimal path forward with lightweight solutions that streamline workflows and expedite patient care. Reduce risk, lower costs and accelerate the adoption of value-based care with access to proactive intelligence that until now has been unavailable. Make whole person care a reality with valuable context that includes both physical and behavioral health experiences.
  • 10
    SAC

    SAC

    SAC

    We offer a range of comprehensive products and solutions, created by computer doctors who take the online systems data and tools offered to a higher level. Cost-effective system to optimize patient flow, improving productivity, performance, and patient experience. Invest more time in your patients and less on your computer. Reduce absenteeism, presenteeism, and disability in your business. Our system allows you to make a difference and improve the monitoring and promotion of your services effectively. Let us help you take care of your older adults. We offer you the necessary tools to improve the effectiveness and efficiency of your processes. We analyze and develop to suit your requirements. We are health computer professionals who understand and speak the health language. It is the platform that offers you less time administering and more caring for patients. Any advance in technology that serves to improve the life of a human being must be shared.
  • 11
    Valenz Health

    Valenz Health

    Valenz Health

    Our single end-to-end platform of fully integrated health plan solutions delivers value and simplifies the complexity of healthcare for employers, members, providers, and payers. Valenz integrates member-centric services with data-driven insights, connecting the dots with personalized service and guidance for high-quality care and improved outcomes. We engage early and often with results-driven education, support, and services to avoid more serious and costly health events. With Valenz, you can have a healthier member population while also achieving plan and member cost savings, year after year. For the tools and transparency you need to make cost-effective, quality-first decisions, let’s find your path to smarter, better, faster healthcare today. With a suite of fully configurable solutions integrated into one ecosystem strategy, the Valenz healthcare ecosystem optimization platform offers extensive visualization of cost, quality, and utilization opportunities.
  • 12
    EazyHMS

    EazyHMS

    Zebricon Technologies

    A complete hospital management system is an all-in-one solution for the hospital's all workstation, we are aiming for a paperless system and especially focusing on reducing management efforts to maintain all its work. Keeping in mind of technology trend we committed to allow access from all devices. Designed with the aim to minimize the efforts of the client and increase their productivity towards their work by serving them faster, easier, and correct outcomes. All you need to access the hospital software application is a browser and an internet connection. This is generally available on a wider range of devices and from anywhere in the world, making SaaS more accessible than traditional business software installation.
  • 13
    MyOutcomes FIT

    MyOutcomes FIT

    MyOutcomes

    FIT eLearning is a new, accelerated, way to learn and implement feedback-informed treatment. Based on the ground-breaking PCOMS evidence-based practice, FIT eLearning is designed to help you gain capabilities and confidence regardless of your learning style. Excellent understanding of PCOMS and FIT. A meaningful outcome and session rating process for clients. Adoption of a simple red, yellow, and green signaling system to keep sessions on track. An ability to map your clinical effectiveness across clients. Identification of your professional baseline. The ability to measure micro improvements in future skills growth. A certificate for 12 hours of online psychotherapy training in feedback-informed treatment. Whether you’re an individual practitioner or part of a larger organization, FIT eLearning helps you develop a culture of feedback and incorporates the outcome and session rating scales (ORS & SRS) into your clinical practice.
  • 14
    Carta Healthcare

    Carta Healthcare

    Carta Healthcare

    Our industry-leading, artificial intelligence (AI)–driven technology converts both structured and unstructured healthcare data into a high-quality, reliable, standardized dataset that can be used across your organization. Accessing data in near real-time from disparate systems, our products and services reduce the burden of manual data abstraction so your administrative and clinical teams can recapture that time for quality and research initiatives. Our products and services allow you to collect, analyze, and act on your data, regardless of data source, therapeutic area, organizational department, or existing reporting, BI, or analytics tools. Atlas uses human expertise and the power of AI to automate and simplify the resource-consuming task of finding and interpreting patient data for clinical registries. Cartographer searches, analyzes, and interprets patient data across all platforms, standardizes those data into a consistent format, and provides relevant data recommendations.
  • 15
    CareStat
    CareStat is SHP’s comprehensive post-acute analytics solution that unites acute care providers, ACOs, payers, and physician groups with skilled nursing facilities (SNF) and home health agencies (HHA). Our goal is to jointly advance the management of patient outcomes, operations, utilization, and post-acute provider partnerships. In addition to SHP’s proprietary readmission algorithms, CareStat uses real-time OASIS (HHA) and MDS (SNF) data, to support patient management across the continuum of care. Reduce readmissions and lower length of stay. Enhance collaboration and partnership efforts. Improve referral patterns and patient satisfaction. Save time by simplifying data transfer of quality and outcome metrics. When it comes to managing trends in a numbers-driven industry, your organization knows the importance of actionable insights. Your initiatives require the proper tools and know-how to operate at peak efficiency.
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