Delegated Clinical Services
Outsourced clinical services combining expertise with workflow-driven technology for small health plans
Service · HybridCompany source
Company profile
About ZeOmega
ZeOmega is a healthcare technology company that delivers comprehensive population health management and care management solutions through its flagship Jiva Healthcare Enterprise Management Platform. The company serves health plans, health systems, accountable care organizations (ACOs), Medicare Advantage plans, and Medicaid-managed care organizations with AI-powered tools designed to optimize quality of care, operational efficiency, and financial performance. The Jiva platform creates a single source of truth by integrating and transforming data from across the healthcare enterprise, enabling AI-powered population health insights that drive cost, risk, and quality improvements. The platform features intelligent workflow automation for care management, embedding best-in-class practices for personalized, whole-health interventions. Key solutions include care management, population health management, quality improvement, risk adjustment, social determinants of health (SDOH) tools, electronic prior authorization (Smart Auth Gateway), member engagement, and utilization management. ZeOmega has been recognized as #1 Best in KLAS for Payer Care Management Solutions for four consecutive years (2022-2025), demonstrating excellence in culture, loyalty, operations, product quality, relationships, and value. The company was also recognized as a Visionary Incumbent in the 2025 Gartner Market Guide for U.S. Healthcare Payer Care Management Workflow Applications and featured for leadership in the 2026 Gartner Market Guide for Intelligent Prior Authorization. Additional recognition includes being named a Leader in the Everest Group Care Management PEAK Matrix Assessment for 2024 and 2025, and a Major Player in the 2024 IDC MarketScape for U.S. Health Plan Prior Authorization Solutions. The company's solutions support value-based care initiatives by combining clinical and claims data to reduce risk, close care gaps, and ensure optimal outcomes. Built-in risk adjustment capabilities help drive success in PMPM payment models and maximize CMS Star ratings performance for Medicare Advantage plans.
Company description ZeOmega official website
Primary marketPopulation Health & Healthcare Analytics
Commercial modelCommercial information available on request
Company presenceOfficial website
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01 · Operating footprint
Where the Company operates
Company-profile context for clinical focus, customers, deployment, integration, milestones, and partnerships.
Clinical focus
No clinical focus areas are currently listed.
Who it serves
- Accountable Care Organizations (ACOs)
- Commercial Health Plans
- Health Plans
- Health Systems
- Medicaid-Managed Care Plans
- Medicare Advantage Plans
Deployment & integration
Cloud Saas · Hybrid deployment with recorded integration context.
Geographic context
MarketsUnited States
Company sourceOfficial website
Company milestones
Platform expansion
Integration of SDOH Social Care solution with Microsoft Cloud for Healthcare; Recognition in 2026 Gartner Market Guide for Intelligent Prior Authorization; Named #1 Best in KLAS for Payer Care Management Solutions 2022-2025; Named Leader in Everest Group Care Management PEAK Matrix 2024-2025
Partnerships
Recorded partners
- Clearlink (delegated clinical services)
- Microsoft (Azure/Cloud for Healthcare)
02 · Flagship portfolio
Products, workflows, and platform capabilities
Selected source-backed Company products and the available commercial context.
HealthUnity Data Interoperability
Data interoperability solution applying analytics to transactions for care gap identification and data exchange
Platform · Cloud SaaSCompany source
HealthUnity Smart Authorization Gateway
FHIR-based electronic prior authorization and interoperability gateway for payer compliance
Api · Cloud SaaSCompany source
Jiva Care Quality Navigator
Performance monitoring solution centralizing HEDIS and CMS Stars quality program data with embedded omnichannel workflow
Software · Cloud SaaSCompany source
Jiva Healthcare Enterprise Management Platform
AI-powered healthcare enterprise management platform for care management, benefits administration, and operational efficiency
Platform · Cloud SaaSCompany source
Jiva Provider Portal
Provider communication portal for streamlined interactions and enhanced quality of care
Software · Cloud SaaSCompany source
Jiva Risk Adjustment Navigator
HCC visualization and analysis solution for risk adjustment data integration into member profiles
Software · Cloud SaaSCompany source
SDOH Social Care Platform
Social determinants of health platform aggregating data for community and personal-level social risk assessment
Platform · Cloud SaaSCompany source
Smart UM Suite
Utilization management suite for care, disease, and utilization management workflows
Software · Cloud SaaSCompany source
03 · Research intelligence
Research Intelligence evidence
Publications, preprints, clinical validation, and regulatory records in Evidence Position order.
Evidence position
Publications, clinical validation, and regulatory records connected to this Company appear here.
Research
Publications & preprints
Healthcare's triple aim. How technology is facilitating collaboration among members, providers and payers.Health management technology · Jan 1, 2013
Clinical validation
Clinical-trial records
No linked records are currently available.
Regulatory
Regulatory records
No linked records are currently available.
04 · Company-reported outcomes
Outcomes and case studies
Company-reported outcomes and customer stories are distinct from linked Research Intelligence evidence.
Improved care gap closure rates
Through Jiva Care Quality Navigator
Better care at lower costs
Via intelligently automated workflows
Maximized CMS Star ratings performance
For Medicare Advantage plans with built-in risk adjustment
Streamlined provider communications and improved internal processes
Major health plan case study with Jiva Provider Portal
Major Health Plan
Streamlined provider communications and improved internal processes
Significantly enhanced quality of care with streamlined provider communications
05 · Leadership
Leadership team
Leadership profiles and professional links from the current Company record.
No active leadership profiles are currently listed.
06 · Company updates
Updates from ZeOmega
Recent articles published on ZeOmega's official website.
07 · HAIC coverage
Coverage and analysis
Health AI Central reporting that mentions this Company.
No HAIC coverage is currently linked to this Company.
08 · Official presence
Company sources and channels
Curated official destinations from the active Company record.
09 · Market pathway
Additional Companies in this Market
Other active Companies in the same market, selected alphabetically from the HAIC directory.
Market context
Population Health & Healthcare Analytics
Companies providing AI-powered analytics for population health management, healthcare data integration and analysis, risk stratification, care gap identification, or value-based care analytics. Focuses on analyzing data across patient populations to improve outcomes at scale and enable data-driven decision-making across health systems.
Explore the full market directory or compare this Company with additional active profiles.
View all Companies in this market
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Linked research, clinical, and regulatory source pathways.
Expanded product, deployment, integration, and partnership research.
Record-level provenance and review context.