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Healthcare payer IT consulting

Payers sit on vast data and rising expectations. Our healthcare payer IT consulting turns that data into real action across claims, cost and member care.

Insurance claim form on a laptop, healthcare payer IT consulting

// The challenge

Rich in data, yet short on insight leaders can act on

Payers hold some of the richest data in healthcare, yet turning it into faster claims, lower cost and better member outcomes is hard when it is trapped in legacy systems. Regulatory and AI expectations only widen the gap.

  • Claims and cost data are stuck in silos
  • Slow-changing legacy core systems
  • Analytics that never reach action
  • AI ambition ahead of readiness

// How we help

From raw claims data to decisions that lower cost and member risk

Data

Analytics Transformation & Managed Analytics

Unify claims and clinical data into insights leaders can trust and act on.

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Analytics

Predictive & Operational Intelligence

Model member risk and cost, then build it into the workflows that act.

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AI delivery

AI Engineering & Agentic Solutions

Operationalize AI across claims and member care, with governance built in.

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Revenue cycle

Revenue cycle optimization

Streamline the shared revenue and claims processes that drive net cost.

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Get more from your data

We help payers turn claims, cost and clinical data into action on spend, risk and member care, with the analytics and AI depth this work demands.

Health plan analyst working at her computer

// Our experts

Meet the experts behind your engagements

Wendy Soethe, VP, Analytics & AI, Pivot Point Consulting

Wendy Soethe

VP, Analytics & AI

28+ years turning payer and provider data into member impact.

AI & Analytics · 28+ yrs
Christopher Rogowski, Partner, Strategic Advisory, Pivot Point Consulting

Christopher Rogowski

Partner, Strategic Advisory

Shapes the data, AI and IT strategy that payers rely on today.

Operations + IT · 20+ yrs
Elizabeth Kerch, Partner, EHR, Pivot Point Consulting

Elizabeth Kerch

Partner, EHR

Guides Epic and EHR strategy from build through optimization.

Epic & RCM · 20+ yrs
//Work with us

Ready to turn your claims and member data into better decisions?

Let’s get started
// FAQs

Payer consulting FAQs

Common questions from payer and health plan leaders evaluating a data and IT partner.

Have any questions? →

Yes. Our healthcare payer IT consulting works across payer and provider data ecosystems, helping health plans unify claims and clinical data and turn it into action on cost, risk and member care.