Text Size

Care Management

Qualis Health takes a patient-centered approach that honors each individual's culture, social context and values—and empowers patients to play an active role in making decisions about their own care. When healthcare is oriented around the unique needs of the patient, it can lead to higher patient satisfaction and better clinical outcomes.

That’s why we’ve been honored in multiple years by the DecisionHealth Platinum Awards as winners and finalists in categories such as Care Coordination, Medicaid Case Management, Utilization Management Program, and more.

Utilization Management

We guide our clients to be responsible stewards of healthcare resources by avoiding overuse, misuse and underuse of health services. Utilization management means ensuring that every dollar spent on patient care is a dollar well spent. At Qualis Health, we make this happen by combining evidence-based criteria, data analysis and high-quality reviews. For the past 40 years, we have used this customized approach to help providers and payers keep their costs down while maintaining the highest quality of care possible for their patients.

Qualis Health provides web-based utilization reviews and targeted review programs based on extensive data analysis. We focus on patient safety and cost containment, leveraging our deep experience with and knowledge of evidence-based protocols to deliver appropriate and optimized care. Our utilization management best practices assure that patients receive the right care, in the right setting, at the right time.

Case Management

Our case managers guide injured and ill patients as they navigate a complex healthcare system to obtain high-quality, patient-centered, cost-effective care. Care coordination is a systematic approach that includes careful assessment of an ill or injured person's unique healthcare needs, individualized care planning, removal of barriers to the receipt of appropriate medical and social services, and continuous monitoring to assure the best possible outcomes.

Contact Us

To learn more about how we can help you, please call or email:

(800) 949-7536


Learn More

»Qualis Health Awards and Recognitions