We Know Healthcare and How It's Delivered Better Than Anyone

At Telligen, we create powerful, data-driven, patient-centered solutions to catalyze healthcare transformation. The result is affordable healthcare for your members, which allows them to achieve the best possible state of health. Telligen utilizes two evidence based criteria sets MCG and InterQual in determining medical necessity.

We offer a full range of flexible solutions including:

Utilization Management

We focus on the promotion of quality of care and eliminating unnecessary services while maximizing healthcare dollars. Our team of highly skilled nurses focus on helping members understand their plan and options they have for receiving high quality, affordable care. Learn more.

Disease Management

We have advanced predictive modeling tools to help identify individuals who would benefit from our programs. Our nurse health coaches build relationships with members, coordinate healthcare treatments, and engage providers on evidence-based practices to encourage their members' progress. Learn more.

Case Management

Our program is designed as a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services. We work with physicians and family members to help achieve the members' goals to bring about better outcomes. Learn more.

Maternity Management

We focus on the care needs of maternity members through ongoing assessment, collaboration, support and care planning. Our goals include promoting the length of the gestational period and improved outcomes for newborns. Learn more.


Our comprehensive wellness solutions will engage members to help the healthy stay healthy, while delivering programs and interventions to help others improve their health. We provide member engagement strategies, an online wellness portal, and, most importantly, results. Learn more by calling 888-323-8431.

Specialty Programs

Need something different? We can tailor a program to fit your needs. Programs can include:

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