Overview
The healthcare payer landscape is undergoing rapid transformation, driven by rising consumer expectations, operational pressures, regulatory shifts and the emergence of new technologies. True transformation demands more than digital tools; it requires intelligent systems that adapt to complex health plan operations.
At Simplify Healthcare Connect 2025, we’re showcasing AI-powered, business-centric solutions that bring intelligent autonomy to key processes from enrollment to claims and care management, reducing administrative burden, improving compliance and enhancing member experiences.
Backed by deep industry expertise, process excellence and our proprietary AI ForceTM platform, we help healthcare payers modernize legacy systems and achieve agile, data-driven outcomes, all while upholding Responsible AI principles.
To learn more about the work we do in Life Sciences and Healthcare, click here.
Focus Areas
Energizing the core
Transform legacy systems into agile, AI-powered ecosystems that accelerate innovation, reduce operational costs and enable rapid scalability.
Impact:
Empower health plans with speed, flexibility and resilience to adapt and thrive in a dynamic, competitive market.
Scaling with Agentic AI
Enable healthcare payers to embed GenAI across operations, improving efficiency, unlocking new revenue streams and fueling continuous innovation throughout the value chain.
Impact:
Accelerate your go-to-market timelines, streamline operational workflows and elevate member satisfaction by embracing AI-first strategies.
Digital Business Process as a Service (BPaaS)
A next-gen, AI-powered service delivery model that unifies business processes, applications and infrastructure to eliminate operational complexity by leveraging HCLTech’s digitalCOLLEAGUE.
Impact:
Achieve measurable outcomes with reduced costs, improved agility and seamless integration across the healthcare value chain.
Data estate modernization and AI
Modernize data ecosystems with cloud native, AI-integrated platforms to power real-time insights, smarter decisions and scalable operations.
Impact:
Drive enterprise agility, operational efficiency and predictive intelligence in the evolving digital health economy.
Our Solutions
- Scaling with Agentic AI
- Energizing the core
- Data estate modernization and AI
- Digital business process-as-a-service
Data estate modernization and AI
Healthcare data aggregation, transformation and analytics
Build a unified data ecosystem powered by cloud, AI and advanced analytics to create 360° member and provider personas and anticipate demand patterns. Automate healthcare data management with standards-based architecture for future-ready operations.
Impact:
Enable real-time insights, proactive decision-making and predictive intelligence to drive agility, operational efficiency and improved patient outcomes.
Agentic Hub
An AI-native orchestration platform built on HCLTech’s AI Foundry, enabling intelligent, context-aware automation across healthcare payer operations. It unifies fragmented systems and workflows through Agentic AI, delivering real-time collaboration, personalized engagement and autonomous decision-making for members, providers, brokers and service teams.
Impact:
Streamline operations, reduce costs and enhance satisfaction with scalable, adaptive automation.
Energizing the core
Total experience – The future of healthcare payer engagement
Deliver personalized, omnichannel experiences across portals, apps and conversational interfaces using AI-driven content management and engagement strategies.
Impact:
Boost member satisfaction, improve retention and strengthen loyalty by creating a seamless, personalized healthcare journey.
Provider lifecycle management
Digitally transform provider onboarding and performance management with AI-led automation and compliant workflows to reduce administrative complexity and improve provider collaboration.
Impact:
Accelerate provider onboarding, ensure regulatory compliance and enhance provider satisfaction for a stronger network and better patient care.
Digital business process-as-a-service (BPaaS)
Health Plan-in-a-Box: An AI-powered healthcare payer solution
Adopt an AI-powered, fully integrated solution and service factory model to run, grow and scale health plan operations at speed.
Impact:
Achieve operational excellence, agility and future-ready consumer personalization to improve engagement and deliver superior member experiences.
DigitalCOLLEAGUE
Empower your workforce with a next-gen AI-powered collaboration platform that automates tasks, streamlines workflows and enables real-time decision-making across healthcare operations.
Impact:
Reduce operational costs, improve service quality and accelerate response times while enabling seamless collaboration and a digital-first culture.
Scaling with Agentic AI
Smart prior authorization
Agentic AI automates the prior authorization process from intake to tracking using an Agentic AI ecosystem that simplifies compliance and reduces administrative burdens.
Impact:
rate care accessibility, improve turnaround times and enhance member and provider satisfaction through intelligent automation.
Smart benefit configuration
An AI-powered solution that streamlines the setup and management of healthcare payer organization benefits with intelligent automation and compliance-ready workflows. It reduces manual effort, ensures accuracy and accelerates time-to-market for new products and plan updates.
Impact:
Improve operational efficiency, reduce configuration errors and enhance member satisfaction through faster, more reliable claims processing
Analyst Recognitions
HCLTech recognized as a Leader in Everest Group’s Healthcare Data, Analytics, and AI Services PEAK Matrix® Assessment 2025
詳細を見るHCLTech recognized as a Leader in Everest Group’s Healthcare Data, Analytics, and AI Services PEAK Matrix® Assessment 2025
Lear moreHCLTech rated as a Leader in ISG Provider Lens™ - Healthcare Digital Services, U.S. 2023
詳細を見るHCL Technologies rated as a Star Performer & Leader in Everest Group Healthcare Payer Digital Services Peak Matrix® Assessment 2022
詳細を見るSuccess Stories
Revolutionizing health plans’ clinical review process with GenAI
HCLTech's GenAI-powered platform transformed a regional Blue Plan's clinical review process, achieving 85% faster reviews and boosting satisfaction for members and providers.
Scaling data with Azure, Databricks, Snowflake and AI for a leading health plan
Discover how HCLTech helped a major US health plan migrate data to the cloud using GenAI, automation, and advanced architecture, boosting performance, user adoption and decision-making.
