ZeOmega Population Health Management

by ZeOmega  · Based in United States → — The Jiva Healthcare Enterprise Management Platform delivers all the tools commercial health plans need to help with population health management while personalizing the care experience, one member at a time.
Family Medicine Hospital Medicine Internal Medicine
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Subscription-based

Overview

ZeOmega’s Jiva Healthcare Enterprise Management Platform is a comprehensive solution designed to empower health plans and other risk-bearing organizations with advanced technology for population health management. The platform leverages AI-powered analytics to identify at-risk and emerging-risk populations, enabling targeted interventions and improved patient care. It integrates various data sources, including claims and social determinants of health (SDOH), to provide high-value, population-level insights. Jiva offers tools for care management, utilization management, quality improvement, risk adjustment, and member engagement, all aimed at optimizing care, streamlining operations, and achieving quality goals. The platform is recognized for its strong integration capabilities, extensive clinical content, and a powerful rules engine, supporting value-based care initiatives and regulatory compliance.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • AI-powered analytics for population risk stratification
  • Data integration from claims, SDOH, and other sources
  • Automated workflows for care management
  • Dashboards and reporting for KPIs, CMS Star ratings, CMS ACO Quality Measures, and NCQA HEDISu00ae measures
  • Care management tools with evidence-based clinical content
  • Member engagement solutions (e.g., Jiva SMS Text)
  • Utilization management with Smart Auth Gateway
  • Risk adjustment navigator
  • Quality improvement solutions (Jiva Care Quality Navigator)
  • Interoperability solutions (HealthUnity)

Use Cases

  • Identifying at-risk and emerging-risk populations for targeted interventions
  • Optimizing care and utilization management efforts
  • Achieving quality goals and associated revenue (e.g., HEDIS, Star Ratings)
  • Streamlining prior authorization workflows with AI and automation
  • Enhancing member engagement and communication
  • Managing complex long-term services and supports (LTSS) populations

What Physicians Need to Know

Risk Stratification Models
ZeOmega's Jiva platform utilizes clinical, claims, and pharmacy data to risk-score and stratify members, allowing care managers to prioritize interventions for at-risk and emerging-risk populations. The platform uses AI-powered population analytics to identify subtle drivers of risk. This helps in anticipating unmet needs, controlling costs, and delivering high-quality care.
Social Determinants Integration
ZeOmega integrates Social Determinants of Health (SDOH) data from various government, claims, and assessment sources into its Jiva platform. This provides a comprehensive view of social needs at individual, population, and geographic levels, enabling targeted interventions. The platform's SDOH Social Care solution is integrated with Microsoft Cloud for Healthcare, enhancing workflow automation and providing a panoramic view of care needs. ZeOmega emphasizes that SDOH impact a significant portion of health outcomes and are crucial for treating the whole person.
Disease Registry Support
While not explicitly called 'disease registry support,' ZeOmega's platform identifies drivers of disease and stratifies populations based on risk scores, which implicitly supports managing specific disease cohorts. AI models are used to predict risk for major cost drivers like opioid use and diabetes.
Care Gap Identification
The Jiva platform assists in identifying gaps in care by leveraging clinical, claims, and SDOH data. It offers solutions like 'Jiva Care Reminders' for proactive care gap closure. The system helps care teams focus on care transitions and pinpoint medication adherence challenges.
Readmission Prediction
ZeOmega's population health management solutions help reduce hospital readmissions. One health plan reportedly reduced readmission rates by 66% using ZeOmega's Jiva solution. The platform supports collaboration between providers and health plans to improve care transitions and reduce readmissions.
Claims Data Analysis
ZeOmega's Jiva platform aggregates and analyzes claims data, alongside clinical, pharmacy, and SDOH data, to identify drivers of disease, stratify populations, and inform care management workflows. This analysis is crucial for understanding risk, gaps in care, and poor outcomes.
Quality Measure Reporting
The Jiva platform includes robust dashboards and reporting tools with pre-built visualizations for CMS Star ratings, CMS ACO Quality Measures, and NCQA HEDISu00ae measures, supporting optimal quality performance. It centralizes quality program data and aims to improve care gap closure rates for value-based care reporting.
Cohort Builder
ZeOmega's solutions enable the identification and stratification of specific groups or cohorts based on risk factors and health needs for targeted interventions. The platform intelligently routes target cohorts to tailored care management workflows.
Geographic Mapping
ZeOmega's SDOH solution provides a view of social needs by area and geographic regions, enabling the identification of risks and needs across these areas. This suggests capabilities for geographic mapping to visualize population health data.
Physician Tip

Leverage ZeOmega's AI-powered analytics to gain a comprehensive, 'whole-person' view of your patients, integrating clinical, claims, and social determinants of health data to accurately identify at-risk individuals and emerging health trends. Utilize the platform's insights to prioritize interventions, personalize care plans, and streamline workflows, focusing on preventative care and addressing social needs that significantly impact health outcomes. Regularly review the quality measure reporting to track performance against benchmarks like HEDISu00ae and CMS Star ratings, and use this data to refine care strategies and improve overall population health.

ZeOmega's Jiva platform offers strong integration capabilities, including its SDOH Social Care solution with Microsoft Cloud for Healthcare and Microsoft Power Platform for enhanced workflow automation. It also integrates with MedeAnalytics for advanced predictive analytics and care management. The platform is designed for seamless workflow integration and data interoperability, aggregating data from various sources like claims, EMRs, and community-based organizations.

Details

Category Population Health Analytics
Pricing Subscription-based
DeploymentCloud, On-premises
Compliance
BAA AvailableUnknown
HIPAA Compliant Yes AI-estimated
FDA Status Unknown
Integrations
EHR Not specified
Specialties Family Medicine, Hospital Medicine, Internal Medicine

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Press & Coverage

ZeOmega
ZeOmega Earns Artificial Intelligence Accreditation from DirectTrustu00ae
ZeOmega received Artificial Intelligence (AI) Accreditation from DirectTrust, recognizing their commitment to responsible AI practices aligned with the NIST AI Risk Management Framework. This accreditation validates ZeOmega's AI governance, risk management, and secure data practices within the healthcare ecosystem.
2026-07
ZeOmega / PR Newswire
ZeOmega and MedeAnalytics Unveil Joint Population Health Solution to Accelerate Value-Based Care
ZeOmega and MedeAnalytics co-developed Population Health Navigator (PHN), a new platform integrating predictive analytics and care management to streamline operations, reduce costs, and improve outcomes in value-based care programs. PHN combines MedeAnalytics' analytics with ZeOmega's care management engine to create a single source of truth for payers and providers.
2025-07
ZeOmega
ZeOmega Recognized in 2025 Gartneru00ae Market Guide for U.S. Healthcare Payer Care Management Workflow Applications
ZeOmega was cited as the “Visionary Incumbentu201d in the 2025 Gartner Market Guide for U.S. Healthcare Payer Care Management Workflow Applications, reflecting its investment in modernizing payer workflows and empowering health plans. The recognition highlights ZeOmega's differentiation in modernizing payer care management amidst rising interoperability and AI-related regulatory demands.
2025-12
ZeOmega
ZeOmega Named a Major Player in 2024 IDC MarketScape for U.S. Health Plan Prior Authorization Solutions
ZeOmega was recognized as a Major Player in the IDC MarketScape: U.S. Health Plan Prior Authorization Solutions 2024 Vendor Assessment report for its innovative use of AI and other technologies to optimize prior authorization processes. This distinction reflects ZeOmega's commitment to improving provider satisfaction and member outcomes through faster, more efficient approvals.
2024-12
ZeOmega Blog
2026 Medicare Advantage Final Rule: Regulatory Round Up & Look Ahead
ZeOmega has compiled best practices to help healthcare teams stay ahead of the digital curve in the shift toward digital quality measurement, specifically addressing the 2026 Medicare Advantage Final Rule. This article provides insights into regulatory changes and strategies for compliance and success.
2025-04
ZeOmega Blog
Integrated Identification & Stratification: Powering Whole-Person Population Health at Scale
This article discusses ZeOmega's Integrated Identification & Stratification framework, which transforms population risk into a strategic advantage for healthcare organizations. It focuses on enabling whole-person population health at scale through effective risk identification and management.
2026-05
ZeOmega White Paper
AI for Population Health Management: Assessing Risk, Building Trust, and Driving Better Outcomes
This white paper explores ZeOmega's methodology for using AI in population health management, including existing models that predict risk for conditions like opioid use and diabetes. It details how AI models are developed, tested, and integrated into existing workflows to improve patient care and reduce costs.
unknown
ZeOmega
ZeOmega Reports Record Demand and Growth for PHM Solution in 2022
ZeOmega experienced a banner year in 2022 with significant growth in client relationships and new product innovations, including the launch of HealthUnity Smart Authorization Gateway. This growth underscores the demand for their care management solutions in the payer, home health, and provider markets.
2023-01

Videos

Product demos, reviews, and walkthroughs for ZeOmega Population Health Management.

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Frequently Asked Questions

ZeOmega's platform utilizes advanced analytics to aggregate data from various sources, including EHRs, claims, and social determinants of health, to create a comprehensive patient view. This allows for risk stratification and the identification of high-risk individuals and cohorts, enabling targeted interventions and proactive care management.
ZeOmega prioritizes data security and is compliant with HIPAA and other relevant healthcare regulations. They employ robust encryption, access controls, and audit trails to safeguard protected health information (PHI) across their platform.
ZeOmega's pricing model is typically subscription-based, varying depending on the size of the organization, the modules selected, and the scope of implementation. Specific costs can include initial setup fees, licensing fees, and ongoing support and maintenance.
While powerful, potential limitations of ZeOmega's platform can include the need for significant data integration efforts, which can be complex and time-consuming. The effectiveness also heavily relies on the quality and completeness of the data fed into the system.
ZeOmega differentiates itself through its comprehensive, integrated platform that covers a wide range of population health functionalities, from data aggregation and analytics to care management and patient engagement. Its flexibility and ability to integrate with diverse healthcare IT systems are often cited as key advantages compared to some competitors.
Yes, ZeOmega's platform is designed for interoperability and can integrate with most major EHR systems. The seamlessness of the integration process can vary depending on the specific EHR and the complexity of the data mapping required, often involving standard APIs and data exchange protocols.

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Suggest an Edit → | Report an issue | Last Verified: 2026-09-03 | First Added: 2026-09-03
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