Join Us at HLTH 2024! Find us at kiosk #3370-26 in the Club Startup pavilion at The Venetian Expo (Level 2).
About Us
Who We Are
CareInsight is an AI-native healthcare intelligence company purpose-built to fix how health plans operate. We replace fragmented, manual workflows with intelligent AI agents that automate operations end-to-end, from member outreach and care plan generation to claims resolution and appeals adjudication, while maintaining full regulatory compliance and audit readiness.
Who We Serve
Medicare Advantage plans. Medicaid managed care organizations. Special Needs Plans (D-SNPs, C-SNPs, I-SNPs). Our customers range from regional plans managing 25,000 lives to national payers scaling across multiple lines of business.
What Makes Us Different
Regulatory-first design. Every agent is built around specific CFR mandates, CMS timelines, and NCQA standards. We don’t bolt on compliance, we build from it. No rip-and-replace. We integrate with QNXT, Facets, TriZetto, and your existing stack via standard APIs. Live in weeks, not years. Measurable results, fast. Our primary customer achieved 40% operational cost reduction within 90 days. Across our agent suite, we deliver 75-95% cost savings on intake, outreach, and admin workflows.
Our Belief
Healthcare operations are broken at scale. Clinical staff are buried in administrative work. Compliance deadlines get missed. Member outreach is manual, expensive, and inconsistent. We believe AI should handle the work machines do best so clinicians, care managers, and medical directors can focus on what only humans can do: clinical judgment, member trust, and better outcomes.
Our Point of View
Health plan operations have reached a breaking point. Administrative costs are rising 15–20% while EBITDA margins compress to 3–5%. Care manager turnover exceeds 25% annually. CMS regulatory requirements grow more complex every year. Manual processes that worked at 50,000 lives collapse at 200,000. The plans that thrive in the next decade will be the ones that automate every operational workflow that doesn’t require human clinical judgment, and invest the savings into the member relationships and clinical outcomes that do.
Mission
Revolutionizing personalized healthcare through innovative technology, delivering tailored solutions that enhance individual health outcomes and empower individuals, caregivers, providers and payers alike.
Core values
Individual centricity
Our foremost priority is to enhance individual care and outcomes. We are dedicated to developing solutions that are accessible, effective, and tailored to meet the diverse needs of individuals.
Empathy
Understanding and addressing the real-world challenges faced by individuals, caregivers, providers and payers is at the heart of what we do. We listen to and empathize with the needs and experiences of our users.
Empowerment
We empower individuals, caregivers, providers and payers with the tools and information they need to make informed decisions, enhancing autonomy in healthcare management.
Adaptability
In a rapidly changing healthcare landscape, we remain agile and responsive to new challenges to and opportunities, ensuring our solutions stay relevant and effective.
Built by Healthcare Operators,
Not Just Technologists
Our founding team brings 80+ combined years in health plan operations, clinical informatics, enterprise AI, and healthcare technology.
Raj brings decades of hands-on experience leading health plan operations across Medicare Advantage, Medicaid, and SNP programs — with deep expertise in care management, utilization management, and regulatory compliance. He founded CareInsight to solve the operational and compliance challenges he witnessed firsthand, building AI that works the way health plans actually operate.
Aswani is an enterprise AI architect with extensive experience building production-grade AI systems for complex, regulated industries — including healthcare interoperability, clinical NLP, and multi-agent orchestration platforms. He leads the technical vision for CareInsight's FHIR-native, HIPAA-compliant AI agent infrastructure that processes millions of member interactions at scale.
See how we help health plans operate smarter — in 30 minutes.
