clinical operations
Get in touch with us Healthcare clinical operations services
Healthcare payers are under increasing pressure to deliver timely, accurate and compliant clinical decisions while managing rising volumes and operational complexity across utilization management, care coordination and quality programs.
Infosys BPM clinical services, with coverage across govt and commercial LoBs, enable organizations to scale clinical operations efficiently while maintaining quality and regulatory compliance. By combining global delivery models with strong clinical domain expertise, we help payers address workforce constraints, reduce administrative burden and improve consistency across clinical workflows.
Key stats
530K+ Clinical pre-certification calls
200K+ Prior authorization cases handled annually
~48K Retrospective UM cases handled annually
Clinical services portfolio
Infosys BPM offers a comprehensive portfolio of AI-enabled clinical services and digital solutions designed to support end-to-end clinical operations across utilization management, care coordination and quality programs. Our portfolio integrates domain-led expertise with workflow automation, advanced analytics and intelligent platforms to streamline clinical processes, improve decision accuracy and enable scalable, compliant operations.
We leverage AI-driven clinical intake and triage, intelligent document processing for medical records, automation-enabled case preparation and data-driven insights to enhance productivity and reduce administrative burden. By integrating predictive analytics, real-time reporting and digital workflow orchestration, we provide greater visibility, faster turnaround and improved consistency across clinical operations.
Through this digitally enabled approach, Infosys BPM helps healthcare organizations optimize clinical workflows, strengthen compliance and governance and drive better clinical and business outcomes at scale.
Services covered
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Utilization management |
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Care management |
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Clinical appeals & grievances |
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HEDIS/stars |
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Risk adjustment |
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Population health |
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Pharmacy utilization review |
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Specialty drug management |
Point solutions
Infosys agentic AI utilization management solution
Infosys ClinDoc AI (Gen AI solution)
Infosys DenialPredict (predictive AI solution)
Clinical workflow optimization solution
Infosys AI Assist AnswerSmart (Gen AI/Conversational AI)
Resource center
Request for services
Get in touch to explore how digitally enabled clinical operations can improve decision accuracy, reduce turnaround time, and enhance operational efficiency across clinical workflows.
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