Government
Networks
Off-the-shelf Medicare Advantage network, customizable Medicaid builds and network management to maintain regulatory compliance and improve access.
Adequacy Confidence
Operational Efficiency
Medicare Advantage and Medicaid-compliant networks built for efficiency and scale.
For Medicare Advantage and Medicaid plans facing strict regulatory requirements, tight timelines, or geographic expansion, Claritev delivers custom or ready-made provider networks that help accelerate market entry and strengthen access to care.
Our Medicare Advantage and Medicaid solutions aim to get plans to market quickly, improve payment accuracy and reduce administrative lift through credentialing and automated provider operations.
Our deployment-ready infrastructure — paired with Claritev’s longstanding history of Network expertise — helps plans launch quickly, reduce administrative burden, and operate with confidence from day one.
From credentialing and network adequacy monitoring to provider data management, we can help streamline operations while supporting payment accuracy and regulatory alignment.
A trusted partner for more than 45 years, Claritev supports annual filings, NCQA-standard credentialing, and ongoing compliance oversight to help government plans maintain performance and meet evolving CMS and state expectations.
Medicare Advantage Network
One flexible model. Network access and operational services working together to help streamline operations, improve efficiency, and support future growth.
Build Your Network to Support Accelerated Growth
Expanding your Medicare Advantage business shouldn’t mean building every network capability from the ground up. Entering new markets requires more than provider access. Health plans must assess network adequacy, maintain accurate provider data, and manage administrative demands while keeping costs and resources in check. Claritev helps health plans navigate these challenges by bringing together an established nationwide provider network, operational services, and Medicare Advantage expertise.
Claritev’s Medicare Advantage Network Solution combines provider network access, network adequacy analytics, and operational services to help payers build and manage their networks more efficiently. By leveraging existing network infrastructure alongside services such as credentialing, provider data management, and claims repricing, health plans can reduce the need to develop and maintain these capabilities internally.
Our flexible model allows payers to select the combination of network access and operational support that aligns with their business needs. This helps reduce administrative complexity, improve visibility into network readiness, and free up internal resources to focus on strategic priorities.
Need more support?
Specialized services provide custom network analytics, data to assist with CMS filings, and ongoing maintenance of client-owned provider contracts. These additional capabilities can help health plans address specific network challenges, navigate evolving business requirements, and support their expansion strategies.
Network access and services working together.
Enter new markets with confidence since Claritev can help strengthen network readiness and reduce operational demands associated with managing a Medicare Advantage network. With the right infrastructure and support in place, health plans can focus on expanding their reach, serving members, and scaling their business while maintaining control over resources and costs.
Engaging insights.
Claritev insights, resources, and case studies.
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How can Claritev help you design a network that improves member access and cuts out-of-network spend?
Learn how Claritev delivers the flexibility and nationwide reach you need to build credentialed, cost-effective access.