As of May 2026, there are 45 SaaS companies in Utilization Management Software. They have combined revenues of $1.8B and employ 14K people. They have raised $1.3B and serve 1.1K customers combined.
Utilization Management Software (UMS) is designed to streamline the review and approval processes for healthcare services, ensuring that treatment choices are necessary, appropriate, and efficient. Primarily used by healthcare providers, payers, and case management teams, UMS helps prioritize care based on clinical urgency, manage approvals and communications, and analyze utilization patterns to prevent overuse or underuse of healthcare services. Typical features of UMS include automated authorization workflows, real-time case tracking, data analytics for utilization patterns, and integrated communication tools for liaising with members and providers. The software plays a critical role in enhancing patient care while improving operational efficiency, making it an essential tool for healthcare organizations looking to optimize resource utilization and manage costs effectively. The common user personas include healthcare administrators, case managers, and clinical staff who require real-time data and insights to make informed decisions. UMS is fundamental for organizations focused on ensuring quality care delivery while simultaneously managing costs and compliance with healthcare regulations.
Sorting: Highest -> Lowest
Showing 10 of 45 companies ranked by annual revenue.
New York, New York, United States
Noom is an American privately held company that provides weight loss, fitness, and mental health services through a subscription-based mobile app. It is a psychology-based digital health platform powered by data, technology, and human coaches that helps millions of people meet their personal health and wellness goals.
Houston, Texas, United States
Simplify Operations. Multiply Impact. symplr is a leader in enterprise healthcare operations software and services with a first-of-its-kind operations platform. Trusted in 9 of 10 U.S. hospitals and 400+ U.S. health plans, symplr optimizes operations and maximizes care powered by our cloud-based workforce, quality, provider data management, and spend solutions. Gain efficiency, reduce complexity, and improve outcomes where it matters most!
Tampa, Florida, United States
Fueling our customers’ success is at the heart of Greenway Health’s work. Driven by our five-point customer pledge and our mission to be trusted advisers, we provide innovative technology, quality services, and strategic partnerships that help practices grow profitably, improve patient outcomes, run efficiently, and remain compliant with federal and state regulations. Greenway’s team of clinical, financial, and technology experts is committed to innovative solutions that keep people healthier and happier. We connect providers to the right information and insights, at the right place and time, so they can make patient-driven care a reality. Greenway partners with organizations and progressive providers across multiple specialties, which translates into millions of lives touched daily by our solutions. For more details, visit www.greenwayhealth.com or call 877-537-0063.
South Jordan, Utah, United States
Health Catalyst helps healthcare organizations turn complex data into meaningful action. Bringing clinical, financial, and operational data together in a trusted foundation, Health Catalyst supports leaders in improving performance with advanced analytics, AI-driven insights, and industry-leading healthcare expertise. The result: clearer insight, better decisions, and measurable, system-wide improvement. Health Catalyst has been recognized by TIME as one its inaugural World’s Top HealthTech Companies and named one of the Best and Brightest Companies to Work For in the Nation by the National Association for Business Resources (NABR) for the ninth year. As a leading employer in healthcare, we take all applicants' security very seriously. If you are applying to a role at Health Catalyst please note: - Health Catalyst never asks for payment or financial information during the recruitment process. - All legitimate job openings are listed on our official careers page: https://www.healthcatalyst.com/careers. - Communications from Health Catalyst will come from official company email addresses ending in @healthcatalyst.com and/or [email protected]
Greenwich, Connecticut, United States
The most complete and composable value-based care software platform for payer, provider and self-funded employer markets
Lake Mary, Florida, United States
CentralSquare Technologies is the trusted provider of public sector software in North America. Our comprehensive, cloud-based platform connects public safety and public administration, helping communities of all sizes run more safely and effectively every day. More than 8,000 agencies rely on CentralSquare to manage critical operations – from dispatch to records, permitting to payroll. We serve with purpose and stand together with our heroes, committed to supporting the public sector with software built for impact.
Mobile, Alabama, United States
A leading provider of revenue cycle management solutions, The SSI Group (SSI) partners with healthcare providers and payers. Our provider product suite includes Patient Access Management, Claims Management, and Performance Management solutions with integrated analytics. SSI connects the industry to 2,600+ payers in 50 states, and powers the business of healthcare with payer solutions, health information sharing, and clinical reporting. A privately held company with more than 35 years of steady growth, we know our clients rely on us to streamline workflow, increase revenue, improve efficiencies, reduce costs, and more. We remain focused on providing the highest level of client service and our associates share in that mission, each and every day. Our clients know it – our average client tenure is over 20 years. Learn how we can help you at www.thessigroup.com
Cincinnati, Ohio, United States
AssureCare is a privately held healthcare technology company that provides innovative care management solutions to commercial and health and human service providers. AssureCare’s flagship software platform, MedCompass, is used by healthcare providers throughout the United States to deliver end-to-end care management for millions of patients daily. MedCompass transforms healthcare management by automating processes and streamlining workflows, thus allowing care professionals to make better decisions that dramatically improve the quality of care and lower costs. AssureCare is considered an industry leader in developing, modular, seamless solutions designed to improve patient outcomes and reduce avoidable costs associated with population health management. AssureCare is a Vora Group company with headquarters in Cincinnati, OH. For more information, please visit https://www.assurecare.com/
Radnor, Pennsylvania, United States
Vālenz Health® is the platform to simplify healthcare – the destination for employers, payers, providers, and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from member experience to payment integrity, plan performance, and provider quality. Valenz elevates expectations to a new level of efficiency, effectiveness, and transparency where smarter, better, faster healthcare is possible. For more information, visit valenzhealth.com.
Pittsburgh, Pennsylvania, United States
TeleTracking is the world’s leading healthcare operations platform. For over 30 years, we have exclusively focused on developing integrated operational solutions and clinical operations expertise that deliver measurable outcomes for healthcare organizations and governments. Our commitment to expanding the capacity to care has resulted in improved quality of care, better workflow and staff management, and significant financial performance savings for over 1,000 hospitals globally. Headquartered in Pittsburgh, Pennsylvania, TeleTracking works across North America and Europe with offices in London and Berlin.
- Must facilitate the review process for healthcare service authorizations. - Should provide real-time analytics on patient utilization data. - Must support automated workflows for handling authorization requests. - Should enhance communication between providers and patients regarding care needs. - Must assist with identifying overutilization or underutilization of services. - Not just focused on billing; must also evaluate clinical necessity and appropriateness.
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