naviHealth
Referral management software
Utilization management software
Health care software
Health care operations software
- Features
- Ease of use
- Ease of management
- Quality of support
- Affordability
- Market presence
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What is naviHealth
naviHealth is a post-acute care management and utilization management platform used by health plans and provider organizations to manage transitions of care and discharge planning. It supports authorization workflows, care planning, and coordination across skilled nursing, home health, inpatient rehab, and other post-acute settings. The product is commonly used to standardize post-acute referrals and monitor length of stay and outcomes across networks. It is positioned around post-acute utilization oversight and care coordination rather than general-purpose referral routing.
Post-acute utilization focus
The platform is purpose-built for post-acute care episodes, including skilled nursing and home health utilization oversight. It supports workflows that align discharge planning, authorizations, and ongoing care management for post-acute services. This specialization can be a better fit than general referral tools when the primary need is managing post-acute length of stay, level-of-care decisions, and transitions.
Care transitions coordination workflows
naviHealth supports coordination between hospitals, post-acute providers, and payer care management teams during transitions of care. It provides structured processes for discharge planning and ongoing monitoring after discharge. These workflows help operational teams manage handoffs and reduce reliance on manual phone/fax follow-up.
Network performance visibility
The product is used to track post-acute utilization patterns and outcomes across provider networks. This can support operational reporting for preferred networks and performance management initiatives. Compared with basic referral routing tools, the emphasis is more on episode oversight and network-level utilization monitoring.
Not a broad referral platform
naviHealth is oriented toward post-acute transitions and utilization management rather than enterprise-wide referral management across all specialties and community services. Organizations seeking a single referral directory and closed-loop referral tracking across medical and social services may need additional systems. Fit can be limited when the primary requirement is general referral intake, scheduling, and multi-service routing.
Integration-dependent deployments
Value depends on integration with EHRs, payer systems, and post-acute provider data feeds to support authorizations, documentation exchange, and status updates. Integration scope and data quality can affect workflow automation and reporting completeness. Implementation effort can be higher in heterogeneous provider networks.
Primarily US post-acute model
The workflows and use cases align closely with US post-acute settings and payer/provider operating models. Organizations outside the US, or those with materially different post-acute pathways, may find mismatches in terminology, processes, and reporting needs. This can limit applicability for international or non-traditional care models.
Seller details
UnitedHealth Group
Minnetonka, Minnesota, United States
2014
Public
https://www.navihealth.com/
https://www.linkedin.com/company/navihealth
