Carelon
Carelon is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. They connect physical, behavioral, social, and pharmacy services with clinical expertise, research, operations, and advanced technology to improve healthcare outcomes, reduce costs, and enhance the care experience. As part of the Elevance Health family, they partner across the healthcare system to build a more connected model of care, supporting health plans, employers, government agencies, providers, and individuals.
Industries
Nr. of Employees
Very Large (1000+)
Products
CarelonRx
A pharmacy benefits manager that offers personalized specialty condition management, digital tools for members, and convenient home delivery services.
Carelon Behavioral Health
Provides a range of behavioral health services including access to a broad network of licensed clinicians, crisis solutions, and employee assistance programs.
Carelon Digital Platforms
Offers digital tools and data-driven insights to simplify healthcare delivery and operations, improving health outcomes through personalized, proactive, and precise interactions.
Carelon Health
Delivers advanced primary care and palliative care, focusing on personalized whole-person care to create better outcomes at lower costs.
Carelon Insights
Includes medical benefits management, payment integrity, and advocacy solutions, aiming to improve healthcare outcomes and efficiency.
Carelon Global Solutions
A managed service delivery organization providing information technology and business operations services for health plans.
CarelonRx
A pharmacy benefits manager that offers personalized specialty condition management, digital tools for members, and convenient home delivery services.
Carelon Behavioral Health
Provides a range of behavioral health services including access to a broad network of licensed clinicians, crisis solutions, and employee assistance programs.
Carelon Digital Platforms
Offers digital tools and data-driven insights to simplify healthcare delivery and operations, improving health outcomes through personalized, proactive, and precise interactions.
Carelon Health
Delivers advanced primary care and palliative care, focusing on personalized whole-person care to create better outcomes at lower costs.
Carelon Insights
Includes medical benefits management, payment integrity, and advocacy solutions, aiming to improve healthcare outcomes and efficiency.
Carelon Global Solutions
A managed service delivery organization providing information technology and business operations services for health plans.
Services
Comprehensive behavioral health offerings including outpatient treatment, crisis response services, employee assistance program components, digital tools, and tailored programs for youth, military, and veterans.
Member-facing navigation and engagement services delivered from a single platform to connect members with personalized clinical and social supports and to coordinate care journeys.
End-to-end utilization management and specialty solutions (radiology, cardiovascular, sleep, surgical, musculoskeletal, oncology, genetic testing) using clinical review, pathway management, and analytics to optimize care and cost.
Coordinated management of post-hospital recovery across home-based and facility settings including clinical review, length-of-service management, transition coordination, and SDOH interventions.
Management of durable medical equipment requests with clinical appropriateness review, delivery coordination, patient training, and portal monitoring of equipment usage.
Authorization and test selection guidance for genetic testing with routing to in-network labs, genetics expert consultation, and claims-authorization reconciliation.
Comprehensive behavioral health offerings including outpatient treatment, crisis response services, employee assistance program components, digital tools, and tailored programs for youth, military, and veterans.
Member-facing navigation and engagement services delivered from a single platform to connect members with personalized clinical and social supports and to coordinate care journeys.
End-to-end utilization management and specialty solutions (radiology, cardiovascular, sleep, surgical, musculoskeletal, oncology, genetic testing) using clinical review, pathway management, and analytics to optimize care and cost.
Coordinated management of post-hospital recovery across home-based and facility settings including clinical review, length-of-service management, transition coordination, and SDOH interventions.
Management of durable medical equipment requests with clinical appropriateness review, delivery coordination, patient training, and portal monitoring of equipment usage.
Authorization and test selection guidance for genetic testing with routing to in-network labs, genetics expert consultation, and claims-authorization reconciliation.
Expertise Areas
- Utilization management and clinical appropriateness review
- Post-acute care management (home and facility)
- Behavioral health services and crisis response
- Care navigation and member engagement
Key Technologies
- Automated real-time utilization review engines
- Clinical decision support systems and treatment pathways
- Advanced analytics and reporting platforms
- Care management and navigation platforms
News & Updates
Innovative, member-focused health plans are reshaping the road to recovery for their members post-hospitalization.
Learn how our partnership with Interim HealthCare has benefitted health plans and members, and how we optimize the quality and affordability of post-acute care.
When it comes to home-based providers, we’ve built a value-based home health network in your local community that your members can rely on.
Improve care quality, address social drivers of health, and close care gaps with our post-acute care solutions.
Discover how a large health plan reduced costs without compromising care using our post-acute facility benefits management solution.
Discover how our Genetic Testing Solution helped Harvard Pilgrim control spending in this case study.
Innovative, member-focused health plans are reshaping the road to recovery for their members post-hospitalization.
Learn how our partnership with Interim HealthCare has benefitted health plans and members, and how we optimize the quality and affordability of post-acute care.
When it comes to home-based providers, we’ve built a value-based home health network in your local community that your members can rely on.
Improve care quality, address social drivers of health, and close care gaps with our post-acute care solutions.
Discover how a large health plan reduced costs without compromising care using our post-acute facility benefits management solution.
Discover how our Genetic Testing Solution helped Harvard Pilgrim control spending in this case study.