By fully integrating the many touchpoints of a member’s health and wellness, a team of clinical professionals work closely together to understand the member’s healthcare needs and assist them to better manage their condition through education, empowerment and specialized support.
MRx Navigate consists of four components that can be offered as a stand-alone product, or part of an integrated solution:
- Navigate Wellness is a program aimed at identifying opportunities for better care and increasing members’ quality of life through educational tools and resources.
- Navigate PopHealth is a population health management program that identifies gaps in care and implements a plan to reduce or eliminate those gaps.
- Navigate UM is a utilization management program that ensures appropriate care and reduces cost across medical and behavioral services, concurrent review of inpatient admission, transition of care assessment, and appeal management. The program is accredited by the
National Committee for Quality Assurance(NCQA) for Utilization Management.
- Navigate Change guides members with acute or ongoing complex conditions and connects members with nurses, behavioral health professionals, and clinical pharmacists.
Through these four programs, MRx Navigate eliminates gaps in care and improves adherence through the use of advanced digital tools, online resources and mobile applications. By leveraging analytics, members who are at risk for non-adherence and ineffective medical and pharmacy utilization are identified and flagged for intervention. Driven by evidence-based algorithms, the program uses data from multiple sources to identify the members in need of a care management or disease management outreach and to determine the intensity of intervention needed.
“As members attempt to access the complex and highly segmented healthcare system, they are faced with many challenges and often have difficulty navigating,” said
MRx Navigate is a flexible and customizable solution available to health plans, employer groups, government entities, third party administrators or as a stand-alone for customers who are seeking data-driven, evidence-based, and personalized interventions to improve the health of their members and provide better overall population health management.
About Magellan Rx Management: Magellan Rx Management, a division of