HITRUST-certified & NCQA-accredited programs solely focused on healthcare.
From insight to impact — smarter solutions that scale
We bring together unrivaled healthcare technology, solutions and expertise to drive change across your healthcare operations while creating better experiences for your members and your business.
Customer Experience
Create connected, human-centered experiences with smart, scalable technology solutions.
Clinical Operations
Support personalized care delivery with care management and prior authorizations.
Provider Network
Deliver efficient, compliant operations — for a better experience for providers and members.
Claims Management
Ensure fast, accurate claims with built-in compliance you can trust.
Risk Adjustment & Quality Performance
Close care gaps and boost quality while protecting and driving revenue.
Choose a partner experienced in connecting the healthcare ecosystem
Your members' well-being is your priority - and supporting it through stronger connections is ours, too.
Born from one of the nation’s largest insurance providers with a global workforce of more than 40,000, Carelon Global Solutions integrates our existing technologies with those of market-leading platform partners in order to support your business process transformation and solve the challenges that matter most.
99%
provider data accuracy
99%
audited claims processed accurately
98%
medical coding accuracy
99%
overall quality in provider commerical calls
Latest at Carelon Global Solutions:
Everest Group names Carelon a Leader in utilization management.
We’re honored to be named a Leader in Everest Group’s 2025 Utilization Management Operations (UM) PEAK Matrix® Assessment. This recognition underscores our commitment to advancing evidence-based, whole-person care.
