ZeOmega
- Company typePrivate
- Founded2001
- HeadquartersFrisco, United States
- Headcount251–500
- GTM typeB2B
- OfferingSoftware
ZeOmega firmographics
Firmographics- Name
- ZeOmega
- Legal name
- ZeOmega, Inc.
- Website
- https://zeomega.com
- Company type
- Private
- Founded year
- 2001
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Ownership category
- akta.pro rank
ZeOmega industry classification
Industry- Product category
- Healthcare Payer Care Management Software
- NAICS
- Computer Systems Design and Related Services (54151)
- SIC
- Services-Prepackaged Software (7372)
- akta.pro primary industry
- Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD)
- akta.pro secondary industries
- Value-Based Contracting Analytics (ACO/MSSP/MA, shared savings/risk) (HLACAHAA), Care Management & Population Health Program Administration (HLAEALAG), HIE Platforms & Network Services (Community/Regional/National) (HLACABAB), Patient Engagement, Education & Messaging Platforms (portal/CRM integrated) (HLALABAJ)
Keywords
Where ZeOmega is headquartered
LocationHeadquarters
- HQ city
- Frisco
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
ZeOmega business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure
Revenue model
- Enterprise Software Licensing - Jiva Platform: ZeOmega provides its Jiva Healthcare Enterprise Management Platform to healthcare organizations including health plans, health systems, Medicare Advantage plans, Medicaid-managed care plans, and ACOs. The platform is sold as an integrated enterprise solution covering care management, population health, utilization management, risk adjustment, SDOH, and quality improvement.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise platform licensing for healthcare payer organizations |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels6 records
ZeOmega product offering
Product offeringCore offering
ZeOmega develops and sells the Jiva Healthcare Enterprise Management Platform, an AI-powered integrated enterprise software suite for healthcare payer organizations including commercial health plans, Medicare Advantage plans, Medicaid-managed care plans, health systems, and Accountable Care Organizations (ACOs). The platform unifies population health analytics, care management, utilization management, risk adjustment, SDOH/social care coordination, quality improvement, and electronic prior authorization with FHIR-enabled interoperability on a single data foundation. ZeOmega has been ranked #1 Best in KLAS for Payer Care Management Solutions for four consecutive years (2022-2025).
Product overview
ZeOmega offers the Jiva Healthcare Enterprise Management Platform as its core unified product, supplemented by modular add-on solutions. The platform provides AI-powered population health analytics, care management, benefits administration, and operational efficiency tools. Key modules include Care Management, Population Health Management, Quality Improvement, Risk Adjustment (with Risk Adjustment Navigator), SDOH Social Care Platform, Smart Auth Gateway (electronic prior authorization), Member Engagement Navigator, Utilization Management, Social Care Connect (closed-loop referral management), and the Smart UM Suite (AI Agent Powered Utilization Management). Additional offerings include Delegated Clinical Services in partnership with Clearlink, and the CareIntel AI analytics solution. The company serves Health Plans, Health Systems, Medicare Advantage, Medicaid, and Accountable Care Organizations. ZeOmega has been ranked #1 Best in KLAS for Payer Care Management Solutions for four consecutive years (2022-2025).
Differentiator
Problem solved
Functional benefit
Brands
- Jiva: Jiva Healthcare Enterprise Management Platform - an AI-powered integrated ecosystem for payer care management, population health analytics, benefits administration, and workflow automation.
- Smart UM Suite
- Social Care Connect
- SDOH Social Care Platform
- Delegated Clinical Services
- Medical Guidelines Digitizer
- Risk Adjustment Navigator
Products and services
- Jiva Healthcare Enterprise Management Platform Central AI-powered healthcare enterprise management platform that provides data integration, analytics, workflow automation, and process optimization for healthcare payers including health plans, Medicare Advantage, Medicaid, ACOs, and health systems.
- Smart UM Suite AI Agent Powered Utilization Management suite offering modular components for end-to-end automation of prior authorization and medical necessity review including FHIR-enabled authorization, predictive reasoning, fax automation, and AI-assisted clinical reviews, designed for health plans and payers.
- Social Care Connect Closed-loop referral management platform that connects health plans and providers with Community-Based Organizations (CBOs) for social care coordination, including automated referral generation, service matching, and omnichannel communication.
- SDOH Social Care Platform Social Determinants of Health analytics and workflow platform that aggregates data from government, claims, and assessment sources to identify health equity gaps and social risk at community and personal levels, integrated with Microsoft Cloud for Healthcare.
- Delegated Clinical Services Clinically grounded operational services delivered on the Jiva platform in partnership with Clearlink, including care management, utilization oversight, and appeals and grievances management for health plans.
- Medical Guidelines Digitizer (MG Digitizer) Scalable AI-powered digitization service that converts medical guidelines from PDF, Word, and HTML into structured clinical assessments, decision trees, and machine-readable formats for prior authorization and utilization management.
- Jiva Risk Adjustment Navigator Risk adjustment solution providing HCC reconciliation, population-level visualization, and risk-adjusted provider performance monitoring with automated error detection across CMS and state source data.
- CareIntel AI Solution AI-powered analytics solution combining rules-based retrospective analytics, supervised machine learning, and decision tree algorithms for population health insights, risk identification, and individual risk mitigation.
- Smart Authorization Gateway FHIR-enabled electronic prior authorization solution with eligibility/benefits checking, integrated payer rules, intelligent network routing, and auto-approval capabilities designed to meet CMS-0057 prior authorization API requirements.
Quantifiable outcome
- Medical Guidelines Digitizer reduces manual workload of converting guidelines by 60-80%
- +1 more outcomes
Companies that use ZeOmega
Customer profileNamed customers2 records
Segments1 record
Ideal customer profiles3 records
ZeOmega technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration3 records
AI capability9 records
Feature10 records
ZeOmega partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- ClearlinkcoreZeOmega and Clearlink formed a strategic partnership to deliver delegated clinical services powered by the Jiva platform. Clearlink brings deep operational and clinical expertise across managed care populations, while ZeOmega provides the digital foundation through Jiva. Together they support health plans with clinically grounded operational services including care management, utilization oversight, and regulatory compliance (CMS, NCQA, URAC). The partnership enables health plans to streamline operations, predict performance, and provide better experiences for members, providers, and plan staff.
Scale indicators4 records
Recent moves6 records
Expansion highlights6 records
ZeOmega competitors and assessment
Company assessmentDirect peers
- Cotiviti: Cotiviti provides payment accuracy, risk adjustment, and population health solutions to health plans, with a strong focus on Medicare Advantage and commercial payers. Its risk adjustment and quality improvement capabilities directly overlap with Jiva's Risk Adjustment Navigator and Quality Improvement modules.
- Medecision: Medecision offers the Aerial platform for care management, utilization management, and population health specifically targeting health plans and payers. It is the most direct head-to-head competitor to ZeOmega's Jiva platform in payer care management workflows.
- Health Catalyst: Health Catalyst provides a data and analytics platform with population health, risk adjustment, and quality improvement capabilities for health systems and payers. Its enterprise analytics focus and payer-relevant modules make it a direct competitor in the population health management space.
- Casenet (Centene Health): Casenet provided care management software for health plans and was acquired by Centene, giving a vertically integrated payer a competing in-house platform. Its TruCare product line is directly comparable to Jiva's care management and UM modules.
- VirtualHealth: VirtualHealth's HELIOS platform provides care management, utilization management, and member engagement for health plans and managed care organizations. It is a focused payer care management competitor with similar target buyers to ZeOmega.
- Arcadia: Arcadia offers a healthcare data platform with population health management, care management, and risk adjustment analytics for payers, providers, and ACOs. Its bundled analytics-plus-workflow offering competes directly with Jiva's population health and value-based care capabilities.
Emerging players
- Innovaccer: Innovaccer offers a healthcare data platform with population health, care management, and value-based care modules, increasingly selling into health plans and providers. It is a fast-growing competitor with a comparable integrated analytics + workflow value proposition.
- Lightbeam Health Solutions: Lightbeam provides a population health management platform with risk adjustment, care management, and quality improvement tools for ACOs, health systems, and payers. Its payer-facing population health analytics are directly comparable to Jiva's modules.
- Clarify Health: Clarify Health offers an enterprise analytics platform combining claims, clinical, and social data for value-based care, network optimization, and population health, increasingly sold to payers. Its analytics-first approach overlaps with ZeOmega's CareIntel and population health insights.
Broad incumbents
- Optum (UnitedHealth Group): Optum is the diversified health services and innovation arm of UnitedHealth Group with broad population health, care management, and analytics offerings used across payers and providers. As a vertically integrated incumbent, it competes with Jiva both as a vendor and through in-sourcing by other large payers.
Market position
Strengths1 record
Weaknesses5 records
Competitive moat6 records
Key risks5 records
Key highlights7 records
Customer concentration
ZeOmega social profiles
Digital presenceZeOmega financial estimates
Financial estimateRevenue estimate
Valuation estimate
ZeOmega leadership team
Management profileNumber of profiles
Profiles7 records
ZeOmega funding detail
Funding detailFunding overview
Funding rounds3 records
Investors4 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ZeOmega M&A and investment
M&A and investmentM&A1 record
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about ZeOmega
What does ZeOmega do?
ZeOmega develops and sells the Jiva Healthcare Enterprise Management Platform, an AI-powered integrated enterprise software suite for healthcare payer organizations including commercial health plans, Medicare Advantage plans, Medicaid-managed care plans, health systems, and Accountable Care Organizations (ACOs). The platform unifies population health analytics, care management, utilization management, risk adjustment, SDOH/social care coordination, quality improvement, and electronic prior authorization with FHIR-enabled interoperability on a single data foundation. ZeOmega has been ranked #1 Best in KLAS for Payer Care Management Solutions for four consecutive years (2022-2025).
Is ZeOmega a public or private company?
ZeOmega is a private company. It is classified as private equity controlled and is currently operating.
When was ZeOmega founded?
ZeOmega was founded in 2001. It employs 251 to 500 people.
Where is ZeOmega based?
ZeOmega is headquartered in Frisco, United States, in the North America region.
How does ZeOmega make money?
One revenue line is on record: enterprise Software Licensing - Jiva Platform.
Who are ZeOmega's main competitors?
Direct peers on record are Cotiviti, Medecision, Health Catalyst, Casenet (Centene Health), VirtualHealth and Arcadia. Emerging players are Innovaccer, Lightbeam Health Solutions and Clarify Health. Optum (UnitedHealth Group) is listed as a broad incumbent.
Does ZeOmega have an API?
Yes. ZeOmega offers FHIR®-enabled APIs supporting semantic interoperability for payer-provider automation and clinical intelligence. The Smart Authorization Gateway is an HL7 FHIR-based solution that enables intelligent prior authorization, supporting automated eligibility and benefits checking, integrated payer rules and guidelines, and intelligent network routing among providers, payers, and delegated vendors. The API meets CMS-0057 Prior Authorization API requirements. The platform supports FHIR-based data exchange for interoperability requirements.
What industry is ZeOmega in?
ZeOmega's product category is Healthcare Payer Care Management Software. Its primary akta.pro industry code is HLACAHAD, Care Management & Coordination Platforms (case/disease management workflows), with a secondary code of HLACAHAA, Value-Based Contracting Analytics (ACO/MSSP/MA, shared savings/risk). Its NAICS code is 54151 and its SIC code is 7372.