QualCare, Inc. is New Jersey’s largest provider-sponsored Managed Care Organization that offers self-funded PPO, HMO network, point of service (POS) network, and open access health plans; third party administration (TPA) services, provider network access, care management services, wellness programs, and a workers’ compensation product. QualCare also provides ACO consultative services and infrastructure, a small group association health plan and insurance management services.
Headquartered in Piscataway, New Jersey, QualCare services over 800,000 members and is owned by 16 non-profit hospitals and physician-hospital organizations, with a clientele that spans health systems, unions, local governments, school boards, and other commercial employers. QualCare’s network covers over 100 acute, specialty and rehabilitation hospitals, as well as over 31,000 physicians and other ancillary providers across New Jersey, Pennsylvania & New York. For more information, please contact Allison Hofmann, Vice President, Client Services & Marketing at 732-562-0833, ext. 2834.
Services: Administrative Services, Case Management Tools/Services, Claims Cost Management, Claims Processing, Disease Management, Call Center, Fraud & Abuse Detection/Services, Medical Management Solutions