GHIT Digital for Healthcare Payers

GHIT Digital – Healthcare Payer (P1) Capability Matrix

Software | Services | Consulting



GHIT Digital is a healthcare-focused digital transformation and technology services firm supporting U.S. Health Plans and Payers (P1) across administrative, clinical, financial, and regulatory workflows. With deep payer-domain expertise and a governance-first approach, GHIT Digital helps health plans modernize legacy environments, adopt AI responsibly, strengthen compliance, and scale operations efficiently.

This capability matrix is designed for procurement, sourcing, and executive leaders to quickly map GHIT Digital’s services to core payer workflows, regulatory obligations, and measurable business outcomes.

 

GHIT Digital – Payer Capability Matrix (Procurement View)

 

Capability Area

Services Covered

What It Means for Payers

How GHIT Digital Delivers

Engagement Models

 

 

 

 

 

Cloud & Infrastructure Transformation

Azure Migration, DC Migration, Cloud Transformation, Infrastructure Managed Services, Managed Network

Modernization of legacy infrastructure into scalable, secure cloud and hybrid environments

Cloud assessments, migration factories, landing zones, network consolidation, managed operations

Project-based, Managed Services, Outcome-based

AI, GenAI & Agentic AI

Agentic AI Governance & Testing, AI Dev Framework, Azure AI Factory, AI/ML Developers, Agentforce POCs

Responsible AI adoption for operations, analytics, and service automation

Governance frameworks, POCs, model validation, enterprise AI pipelines

Consulting, POC-to-Production, COE Support

Application Modernization & DevOps

BizTalk Retirement, Azure ADO Assessment, QA Extension, AI-Powered Development

Faster, safer application delivery and modernization

DevSecOps, CI/CD optimization, legacy decoupling, automated testing

Staff Augmentation, Managed Delivery

Security, Risk & Compliance

CISO as a Service, API Security, PAM, SOC/GRC, Server Security, SOX/SOC Cloud Migration

Regulatory readiness and cyber resilience

Risk assessments, IAM, SOC operations, compliance-aligned controls

Advisory, Managed Security Services

Care, Clinical & Payer Operations

HCMACS, ICS Consulting, Patient Matching, Enrollment Extension

Improved care coordination, enrollment accuracy, and data integrity

Workflow optimization, interoperability, platform consulting

Consulting, Platform Support

GHIT Digital – Payer Workflow Alignment & Use Cases

 

Payer Workflow Domain (P1)

GHIT Digital Capabilities

What GHIT Digital Delivers

Representative Payer Use Cases

 

 

 

 

Finance & Revenue Operations

Accounts Payable, SAP S/4HANA, SAP IBP

AP automation, ERP modernization, audit-ready finance operations

AP cycle-time reduction; SOX-aligned financial controls

Enrollment & Eligibility

Enrollment Extensions, Data Migration, Integration Modernization

Scalable enrollment workflows with regulatory alignment

Open enrollment surge handling; CMS & state exchange integration

Claims Operations

AI/ML Consulting, Data Quality, QA Expansion

Intelligent claims triage, validation, and testing

Claims leakage reduction; claims analytics & repair

Care Management (UM / CM / DM)

HCMACS, Integrated Care Consulting, AI Governance

Care coordination platforms with compliant AI adoption

UM automation; care gap identification

Member & Provider Experience

Contact Center Modernization, Digital Mailroom, Adobe Enablement

Omnichannel engagement and faster correspondence

AI call deflection; digital EOB & communications

Security, Risk & Compliance

CISO as a Service, SOC, GRC, PAM, SailPoint

End-to-end security leadership and compliance execution

HIPAA audits; identity governance & access reviews

 

Why GHIT Digital for Healthcare Payers (P1)

 

  • Payer-first mindset (Claims, Enrollment, UM, Compliance)
  • Governance-led AI & Cloud adoption
  • Platform-agnostic but platform-deep (Pega, SAP, Snowflake, Azure, ServiceNow)
  • Procurement-friendly delivery models (Projects, Managed Services, Staff Augmentation)
  • Single partner across Transform + Run

 

 

Procurement & Sourcing Value

 

  • Clear capability-to-workflow traceability
  • Supports RFPs, MSAs, and vendor rationalization
  • Reduces vendor sprawl
  • Aligns IT spend with regulatory and operational outcomes

 

Talk to us for DEMO I Share your RFP

 

Monika Vashishtha, MBA, PMP

Monika@GHIT.digital 

646.734.6482

 

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