GuidingCare Care Management

JSON twin: https://www.healthaidb.com/software/guidingcare-care-management.json

Company Name

HealthEdge

Product URL

https://healthedge.com/solutions/care-management-workflow/guidingcare/

Company URL

https://healthedge.com

Categories

• care Management
• healthcare It
• clinical Workflow Automation
• data Integration
• patient Engagement
• care Coordination
• health Data Analytics
• mobile Health
• population Health
• utilization Management
• Workflow Management
• Clinical Coordination
• Healthcare Analytics
• Population Health Management

Summary

GuidingCare Care Management by HealthEdge is a comprehensive platform designed to enhance care coordination, improve health outcomes, and reduce operational inefficiencies for health plans through advanced automation and real-time data integration.

Description

GuidingCare Care Management offers tools for advanced care coordination, automated care planning, community referrals, and mobile clinician support, all integrated into a unified platform to streamline workflows and provide whole-person care.

Api Available

yes

Certifications

• HITRUST Certification
• NCQA Population Health Management Prevalidation
• AA Certification for HEDIS Measures Subset
• CA Veracode Verified Status

Company Founding

2004

Company Offices

• United States
• India

Compliance

• HIPAA
• HITRUST
• NCQA
• CMS
• ISO 27001

Customers

• Health plans and providers utilizing GuidingCare Care Management.

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Advanced care coordination tools
• Automated care planning
• Community referrals integration
• Mobile clinician application with offline capabilities
• Integrated platform with comprehensive care records
• Utilization management with authorization lifecycle support
• Appeals and grievances management
• Authorization portal for provider interactions
• Business intelligence with over 50 standard reports
• Population health management with gaps-in-care analytics
• Member engagement through omnichannel communications
• GuidingCare University for digital training
• GuidingCare Rules Designer for business rule management
• Pediatric population health tracking
• GuidingSigns analytics for clinical decision support

Id

SW1460

Integration Partners

• HealthEdge

Integrations

• HealthRules Payer
• Wellframe
• Social services platforms
• Provider systems

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• health plans
• payer organizations

Optional Modules

• GuidingCare Utilization Management
• GuidingCare Appeals & Grievances
• GuidingCare Authorization Portal
• GuidingCare Business Intelligence
• GuidingCare Population Health Management
• GuidingCare Member Engagement
• GuidingCare University
• GuidingCare Rules Designer
• GuidingCare Pediatric Population Health
• GuidingSigns Analytics

Os Platforms

• Web
• iOS
• Android

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization

Product Code

SW1460

Product Name

GuidingCare Care Management

Ratings

• 3.8/5 on G2

Regions Available

• United States

Related Urls

• https://elion.health/products/healthedge-care-management-workflow

Release Year

2018

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA

Specialties

• Care Coordination
• Utilization Management
• Population Health Management
• Healthcare Analytics
• Mobile Health
• Patient Engagement
• Workflow Management
• Data Integration
• Clinical Coordination
• Healthcare It

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• care managers
• health plan administrators
• clinicians
• utilization management staff
• healthcare providers
• field-based clinicians

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• You definitely need the proper training in order to perform your daily task.
• Innovative platform, it manages to properly gather the information.
• Simplifies things from a case management perspective.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "GuidingCare Care Management",
  "company_name": "HealthEdge",
  "product_url": "https://healthedge.com/solutions/care-management-workflow/guidingcare/",
  "company_url": "https://healthedge.com",
  "related_urls": [
    "https://elion.health/products/healthedge-care-management-workflow"
  ],
  "product_code": "SW1460",
  "summary": "GuidingCare Care Management by HealthEdge is a comprehensive platform designed to enhance care coordination, improve health outcomes, and reduce operational inefficiencies for health plans through advanced automation and real-time data integration.",
  "description": "GuidingCare Care Management offers tools for advanced care coordination, automated care planning, community referrals, and mobile clinician support, all integrated into a unified platform to streamline workflows and provide whole-person care.",
  "categories": [
    "care Management",
    "healthcare It",
    "clinical Workflow Automation",
    "data Integration",
    "patient Engagement",
    "care Coordination",
    "health Data Analytics",
    "mobile Health",
    "population Health",
    "utilization Management",
    "Care Management",
    "Healthcare It",
    "Workflow Management",
    "Data Integration",
    "Patient Engagement",
    "Clinical Coordination",
    "Healthcare Analytics",
    "Mobile Health",
    "Population Health Management",
    "Utilization Management"
  ],
  "market_segment": [
    "enterprise",
    "health plans",
    "payer organizations"
  ],
  "target_users": [
    "care managers",
    "health plan administrators",
    "clinicians",
    "utilization management staff",
    "healthcare providers",
    "field-based clinicians"
  ],
  "specialties": [
    "Care Coordination",
    "Utilization Management",
    "Population Health Management",
    "Healthcare Analytics",
    "Mobile Health",
    "Patient Engagement",
    "Workflow Management",
    "Data Integration",
    "Clinical Coordination",
    "Healthcare It"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States",
    "India"
  ],
  "company_founding": "2004",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web",
    "iOS",
    "Android"
  ],
  "features": [
    "Advanced care coordination tools",
    "Automated care planning",
    "Community referrals integration",
    "Mobile clinician application with offline capabilities",
    "Integrated platform with comprehensive care records",
    "Utilization management with authorization lifecycle support",
    "Appeals and grievances management",
    "Authorization portal for provider interactions",
    "Business intelligence with over 50 standard reports",
    "Population health management with gaps-in-care analytics",
    "Member engagement through omnichannel communications",
    "GuidingCare University for digital training",
    "GuidingCare Rules Designer for business rule management",
    "Pediatric population health tracking",
    "GuidingSigns analytics for clinical decision support"
  ],
  "optional_modules": [
    "GuidingCare Utilization Management",
    "GuidingCare Appeals & Grievances",
    "GuidingCare Authorization Portal",
    "GuidingCare Business Intelligence",
    "GuidingCare Population Health Management",
    "GuidingCare Member Engagement",
    "GuidingCare University",
    "GuidingCare Rules Designer",
    "GuidingCare Pediatric Population Health",
    "GuidingSigns Analytics"
  ],
  "integrations": [
    "HealthRules Payer",
    "Wellframe",
    "Social services platforms",
    "Provider systems"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITRUST",
    "NCQA",
    "CMS",
    "ISO 27001"
  ],
  "certifications": [
    "HITRUST Certification",
    "NCQA Population Health Management Prevalidation",
    "AA Certification for HEDIS Measures Subset",
    "CA Veracode Verified Status"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Health plans and providers utilizing GuidingCare Care Management."
  ],
  "user_reviews": [
    "You definitely need the proper training in order to perform your daily task.",
    "Innovative platform, it manages to properly gather the information.",
    "Simplifies things from a case management perspective."
  ],
  "ratings": [
    "3.8/5 on G2"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2018",
  "integration_partners": [
    "HealthEdge"
  ],
  "id": "SW1460",
  "slug": "guidingcare-care-management",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/guidingcare-care-management.json"
  }
}