PROVIDER MANAGEMENT
End-to-end provider operations. On one platform.
Provider management for health plans. Credentialing, provider data management, and ongoing compliance monitoring on one platform. Replace Cactus and legacy systems. Go live in 90 days. Cut admin costs 40%, increase data accuracy 30%.
- Credentialing + Provider Data Management + monitoring on one platform
- Cut admin costs 40%, increase data accuracy 30%
- Go live in 90 days, replace Cactus and legacy systems
Book a 20-minute demo
See end-to-end provider management consolidated on one modern platform.
Trusted by leading health plans, digital health companies, and provider networks
Provider operations — the numbers
- 40-60%reduction in directory errors
- 90%reduction in manual roster reconciliation effort
- 50%reduction in NSA non-compliance risk
- 8of the 10 publicly listed US Health Plans are CertifyOS Clients.
THE PROBLEM
Provider operations span 5+ systems at most plans. It shouldn't.
Cactus for credentialing. Excel for tracking. A separate tool for compliance monitoring. Another for directory updates. A directory platform on top.
Provider operations sprawl is the silent tax on every health plan — paid in headcount, integrations, audit prep, and provider experience. CertifyOS consolidates it all on one modern platform: 40% lower admin costs, 30% higher data accuracy, 90-day go-live.
One platform. Five integrated workflows.
Credentialing + PSV
NCQA-certified CVO with end-to-end primary source verification, committee management, and audit trail. 99.8% accuracy.
Master Data Management
One golden record per provider with full lineage and field-level survivorship. Aggregate data from CAQH, NPPES, primary sources, and internal systems into a single source of truth that feeds claims, directories, prior auth, and more.
Compliance monitoring
Continuous license, DEA, NPDB, OIG, and SAM monitoring across 50 states. Real-time alerts. Recredentialing automated.
Provider portal + analytics
Self-service provider portal plus enterprise analytics for ops leaders. End spreadsheet reporting and per-payer status calls.
Why plans consolidate provider operations.
CertifyOS
- One platform across the provider lifecycle
- 40% lower admin costs
- 30% higher data accuracy
- 90-day implementation
- NCQA-certified, SOC 2 Type 2
5-tool legacy stack
- Cactus + Excel + compliance tool + directory platform
- Headcount-heavy ops
- Stale provider data + directory errors
- 9-18 month implementations per tool
- Audit prep across multiple systems
FROM OUR CLIENTS
“Oscar Health unlocked 29% in annual cost savings. Alma reduced annual provider costs by 85%. Select Health hit 99.8% file-level accuracy. The numbers come from automation that just works — and from a team that shows up the way enterprise software promises but rarely delivers.”
— CertifyOS Client Outcomes