Clearlink Partners

What Clearlink Partners does

Clearlink Partners is a privately held, Charleston, South Carolina-based managed care consulting firm founded in 2018 that delivers clinical, operational, and delegated services to US health plans and risk-bearing entities. The firm's service portfolio is organized around three core pillars—Clinical Management, Operational Management, and Delegated Clinical Services—and extended through specialized practices covering population health management, payment integrity, risk adjustment analytics, pharmacy spend management, behavioral health integration, regulatory compliance and NCQA accreditation, quality program design, provider operations, product and benefit design, claims configuration, core systems transformation, and healthcare analytics. Clearlink also offers a Business Process as a Service (BPaaS) delivery model that combines cloud-based platforms with embedded expert teams for utilization management, appeals and grievances, and medical management operations.

The firm executes engagements through a five-step methodology (Discovery, Analysis, Strategy, Delivery, Optimization) in which specialized consultants are embedded as extensions of client organizations. Clearlink does not operate a proprietary technology platform; its IP is concentrated in domain expertise, repeatable processes, and a consultant bench with both clinical (RN, DNP, CCM, CCDS) and operational credentials. The firm has demonstrated measurable client outcomes, including raising an NCQA compliance score from 63% to 97% for a managed care plan client, doubling membership and tripling associated revenue for a regional health plan, and expanding a prior authorization engagement from a 60-day scope to an eight-month program.

Clearlink's commercial model is B2B fee-for-service professional services sold through direct, consultative enterprise engagement with managed care organizations, Medicaid plans, Medicare Advantage plans, Special Needs Plans, and risk-adjusted entities. Go-to-market is expertise-led, anchored on thought leadership content (blog, resource library, newsletter, social media) and direct outreach by specialized consultants. The firm is independent with no disclosed parent company, institutional investor, or funding rounds; ownership appears to be founder or management-held. Customer mix is concentrated in enterprise health plans, with named relationships including Neighborhood Health Plan of Rhode Island and Johns Hopkins Health Care.

Name

Clearlink Partners

Legal name

Clearlink Partners

Website

https://clearlinkpartners.com

Company type

Private

Founded year

2018

Operating status

Operating

Short description

Clearlink Partners is a private managed care consulting firm serving US health plans across Medicaid, Medicare Advantage, Special Needs Plans, and complex care populations through clinical, operational, and delegated services delivered via embedded consultant teams and a BPaaS model.

Ownership category

akta.pro rank

Headquarters

HQ city

Charleston

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Marketing or Sales, Operations, Technology or R&D, Others

Revenue model

1. Healthcare Management Consulting Services: Clearlink Partners generates revenue through professional consulting engagements with managed care organizations. Services include clinical management consulting, operational management consulting, delegated clinical services, and end-to-end managed care program design and implementation. The firm deploys specialized consultants as an extension of client organizations to deliver comprehensive solutions across the managed care lifecycle, including program and project delivery, core systems transformation, and population health program development. Revenue is derived from fee-for-service consulting engagements scoped to specific client needs.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels6 records

Core offering

Clearlink Partners is an end-to-end managed care consultancy that sells Clinical Management Services, Operational Management Services, and Delegated Clinical Services to U.S. health plans, supplemented by specialized service areas such as Population Health Management, Payment Integrity, Risk Adjustment Analytics, Behavioral Health Integration, Regulatory Compliance & Accreditation, Quality Program Design, and a Business Process as a Service (BPaaS) delivery model. Engagements are delivered through a five-step methodology (Discovery, Analysis, Strategy, Delivery, Optimization) in which specialized consultants operate as an extension of the client's organization across Medicaid, Medicare Advantage, Special Needs Plans, and complex care populations.

Product overview

Clearlink Partners is an independent managed care consultancy offering an integrated suite of clinical and operational management services. The portfolio centers on three core service pillars: Clinical Management Services, Operational Management Services, and Delegated Clinical Services. These core services are supplemented by specialized practice areas including Population Health Management, Payment Integrity, Risk Adjustment Analytics, Pharmacy Spend Management, Behavioral Health Integration, Regulatory Compliance & Accreditation, Quality Program Design, Provider Operations, Product & Benefit Design, Claims Configuration, Core Systems Transformation, and Healthcare Analytics Management. The company also offers a Business Process as a Service (BPaaS) model that combines cloud-based platforms with embedded expert teams to deliver scalable, automation-enabled service delivery. Clearlink serves Managed Medicaid, Medicare Advantage, Special Needs Plans (SNPs), complex care populations, and risk-adjusted entities, providing end-to-end consulting from strategy through execution.

Differentiator

Problem solved

Functional benefit

Products and services

• Clinical Management Services Comprehensive clinical solutions for managed care organizations, offering transformational and holistic clinical approaches for complex populations with a focus on best-in-class outcomes, cost reduction, and accelerated financial performance. Designed for managed care plan clinical leaders seeking to elevate care management for Medicare, Medicaid, SNP, and complex care members.
• Operational Management Services End-to-end operational consulting for health plans, covering program and project management, system optimization, data-driven innovation, and cross-departmental alignment across the complex operational, financial, and technological functions of a shifting healthcare environment.
• Delegated Clinical Services Co-sourced clinical service delivery models that extend client organizations' capabilities, including delegated care management support, RN case management deployment, and full-lifecycle clinical program support for managed care plans.
• Population Health Management Strategic consulting for implementing and improving population health management programs at managed care organizations, including risk stratification, member engagement, care coordination, and outcome measurement.
• Payment Integrity Payment accuracy and cost-containment consulting that connects policy governance, claims operations, analytics, clinical review, and vendor management into a coordinated framework for managed care organizations.
• Risk Adjustment Analytics Risk adjustment program support spanning diagnosis capture coordination, coding optimization, and compliance management across provider engagement and clinical workflows for managed care organizations.
• Behavioral Health Integration Integrated behavioral health strategy consulting covering behavioral health integration, mental health parity, care management strategy, and substance use disorder program development for managed care plans.
• Regulatory Compliance & Accreditation Compliance readiness services including NCQA Health Equity Accreditation preparation, HEDIS score improvement, and regulatory compliance strategy for managed care organizations.
• Business Process as a Service (BPaaS) Cloud-based service delivery model blending digital platforms with embedded expert consulting teams, providing scalable, automation-driven support for utilization management, appeals and grievances, and medical management operations.

Quantifiable outcome

• Boosted NCQA compliance score from 63% to 97% for a Managed Care Plan client through streamlined complex case management program design
• +2 more outcomes

Named customers2 records

Segments5 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

One partnership is on record.

• Vault VerifyminorOthersClearlink Partners directs employment and income verifications through Vault Verify's secure verification environment, using company code '23041'. This is a vendor relationship for background/employment verification services rather than a strategic partnership.

Scale indicators3 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• Health Management Associates (HMA): A national healthcare consulting firm focused on Medicaid, Medicare, and behavioral health policy and program design. Highly comparable to Clearlink in buyer base (state Medicaid agencies, managed care plans) and service mix (clinical operations, population health, regulatory compliance).
• Sellers Dorsey: Healthcare consultancy with deep Medicaid, Medicare, and managed care expertise serving state agencies, health plans, and providers. Closely comparable to Clearlink in service scope (program design, payment reform, compliance) and customer profile.
• Manatt Health: Integrated healthcare consulting and legal advisory practice with strong Medicaid, Medicare Advantage, and SNP practices. Comparable as a specialist serving payers and government programs, though larger and with deeper legal/policy capabilities.
• Avalere Health: Healthcare strategy and policy consultancy advising payers, providers, and life sciences companies. Comparable in serving Medicare Advantage, Medicaid, and ACA-driven compliance work, with a broader data/analytics overlay than Clearlink.
• The Lewin Group: Healthcare policy and management consulting practice with strong Medicaid managed care, Medicare, and population health expertise. Comparable in mission and buyer base, though operates at greater scale under the QuintilesIMS/IQVIA umbrella.

Broad incumbents

• Deloitte (Healthcare Consulting): Global professional services firm with a large healthcare consulting practice covering payers, providers, and government health programs. Overlaps with Clearlink on Medicare/Medicaid transformation engagements but competes across a much broader portfolio.
• Accenture (Health & Public Service): Global consultancy with a dedicated Health & Public Service practice serving payers and government programs on large-scale transformations. Competes with Clearlink on health plan operations, core systems, and program management engagements at enterprise scale.
• Optum Advisory (UnitedHealth Group): Healthcare consulting arm of UnitedHealth Group serving payers, providers, and government programs with strategy, operations, and analytics advisory. Highly comparable in managed care focus but backed by the Optum data and platform assets Clearlink lacks.
• KPMG (Healthcare): Big Four advisory practice with a dedicated healthcare industry group covering payers, providers, and government programs. Overlaps with Clearlink on regulatory, operational, and compliance engagements, with broader delivery scale.
• Mercer (Health & Benefits): Global consulting firm with deep health and benefits advisory practice serving employers, health plans, and government programs. Adjacent rather than direct overlap, but competes for payer-side strategy and benefits design engagements Clearlink also targets.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/ClkPartners
• Facebookfacebook.com/clearlinkpartners
• LinkedInlinkedin.com/company/clearlink-partners

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Clearlink Partners