ClearCore Insights

What ClearCore Insights does

ClearCore Insights is a US-based, privately held healthcare consulting firm founded by Karen Norris and headquartered in Philadelphia. The firm serves enterprise healthcare payer organizations—commercial health plans and Medicare Advantage plans—undergoing technology, operational, or regulatory transformations. Its core offering is the proprietary RRR Framework® (Readiness, Resilience, Results), a leadership system designed to identify and close the "Readiness Gap" before transformation execution accelerates, supported by trademarked diagnostic tools including the 10-Point Readiness Audit™, the Resilience Under Pressure assessment, the 5-Point Program, and the CMS-0057-F Business & Operational Primer.

The business is structured as a professional services and managed services consultancy with quote-based engagements; pricing is not publicly disclosed and there is no software product, platform, or recurring SaaS component. Services are delivered directly by a small team (1-10 employees) led personally by Karen Norris, who brings 35 years of payer-side and vendor-side healthcare experience. Go-to-market is sales-led and event-driven, combining enterprise field sales (direct outreach, complimentary consultations) with thought leadership channels including LinkedIn, an active blog (dated 2024-2025), gated diagnostic downloads, and executive forums/webinars—most recently a co-hosted webinar with Itiliti Health on CMS prior authorization mandates. The firm has documented 50+ payer transformations impacting 70M+ members, holds WBENC certification as a women-owned business, and is the sole owner of its proprietary IP with no disclosed institutional investors or parent company.

Name

ClearCore Insights

Legal name

ClearCore Insights

Website

https://clearcoreinsights.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

1–10 employees

Short description

ClearCore Insights is a US healthcare consultancy that helps health plan leaders close organizational readiness gaps before payer transformations, using its proprietary RRR Framework® and related diagnostic tools delivered through founder-led consulting engagements.

Ownership category

akta.pro rank

Headquarters

HQ city

Philadelphia

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Advisory and Consulting Services: Transformation readiness consulting and advocacy services for healthcare payer organizations. Engagement typically involves assessments, planning, executive coaching, and program management support throughout payer technology implementations and CMS compliance initiatives.
2. Executive Training and Education: Readiness Reviews and diagnostic tools provided as part of consulting engagements to help organizations assess and improve transformation readiness.

Go-to-market motion3 records

Distribution channels2 records

Marketing channels7 records

Core offering

ClearCore Insights provides transformation readiness consulting services to healthcare payer organizations, helping health plan leaders identify and close the "Readiness Gap" before execution accelerates. Its core methodology is the proprietary RRR Framework® (Readiness, Resilience, Results), delivered through consulting engagements, readiness audits, and executive advisory work tailored to payer technology implementations and CMS compliance initiatives.

Product overview

ClearCore Insights is a healthcare consulting firm specializing in payer transformation and organizational readiness. The company's core offering is the RRR Framework® (Readiness → Resilience → Results), a proprietary transformational methodology. Supporting this core framework are several assessment and diagnostic tools including the Transformation Readiness Audit™ (10-Point Readiness Audit), the Resilience Under Pressure diagnostic, and the 5-Point Program for transformation recovery. The company also provides the CMS-0057-F Business & Operational Primer as a resource for regulatory compliance preparation. All offerings are delivered through consulting engagements rather than a software platform, with services focused on strategy & foresight, market analysis, leadership advocacy, specialty integrations, project assessments, and implementation & operational readiness for health plans.

Differentiator

Problem solved

Functional benefit

Brands

• RRR Framework: Proprietary transformational framework for healthcare payer leadership (Readiness, Resilience, Results).
• 10-Point Readiness Audit
• CMS-0057-F Business & Operational Primer

Products and services

• RRR Framework® A proprietary leadership system for closing the Readiness Gap in payer transformations, addressing alignment, governance, and risk visibility before decisions lock in; maintaining leadership control as conditions change; and ensuring transformation delivers lasting improvement beyond go-live. Delivered as consulting engagements to healthcare payer organizations.
• Transformation Readiness Audit™ (10-Point Readiness Audit) An executive-level diagnostic tool that evaluates whether an organization is prepared across 10 areas most predictive of transformation success, including strategic alignment, governance & accountability, change saturation, data stewardship, operational continuity, vendor readiness, compliance dependencies, workforce adoption, communication, and resilience. Offered to healthcare payer leaders via email signup.
• Resilience Under Pressure Diagnostic (5 Indicators of Organizational Stability) A diagnostic assessment helping payer leaders identify where clarity, alignment, and readiness can be strengthened within their organizations by evaluating five indicators of organizational stability under pressure. Delivered via email after signup.
• 5-Point Program for Healthcare Transformation A structured methodology for health plans to assess, realign, and achieve transformation goals across five steps: Assess, Align, Accountability, Achieve, and Accomplish. Used as a recovery and re-alignment framework when payer transformations are off-track.
• Transformation Readiness Review™ A complimentary consultation service where ClearCore Insights experts review audit results and provide clarity on organizational readiness, serving as the on-ramp to deeper consulting engagements for payer leaders.

Quantifiable outcome

• 70% reduction in implementation risk
• +4 more outcomes

Named customers2 records

Segments1 record

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Partnerships

One partnership is on record.

• Itiliti HealthminorStrategic or Co-development Partner · 1 April 2025ClearCore Insights partnered with Itiliti Health to host a webinar on prior authorization reform and CMS mandates. The session brought together CEO Karen Norris and Itiliti Health CEO Michael Lunzer to explore how payers can approach CMS mandates as transformation opportunities rather than compliance burdens. The collaboration was part of Itiliti Health's 2025 Prior Auth Expectations Series.

Scale indicators7 records

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• Deloitte (Healthcare practice): Global consulting firm with a large healthcare payer transformation practice serving health plans on technology implementations and regulatory readiness. Competes in the same RFPs but offers broader scale and integrated technology services.
• Optum Advisory (UnitedHealth Group): Large-scale healthcare advisory arm of UnitedHealth Group, offering payer consulting, transformation, and analytics at scale. Overlaps with ClearCore on payer transformation readiness but operates with vastly greater resources and breadth.
• Accenture (Health): Global consulting and technology services firm with a substantial healthcare payer practice. Comparable in transformation readiness and large-scale implementation advisory, though operates at far greater scale and with broader service offerings.
• McKinsey & Company (Healthcare practice): Top-tier management consultancy serving health insurers on strategy, transformation, and operational improvement. Competes for executive-level payer advisory engagements but is not payer-specialized at ClearCore's depth.

Direct peers

• Pivot Point Consulting: Healthcare IT and management consultancy serving payers and providers on strategic transformation projects. Similar boutique positioning and advisory-led delivery model to ClearCore.
• Nordic Consulting: Healthcare consulting firm focused on EHR and technology transformation, with payer and provider practices. Directly comparable in advisory services for healthcare technology implementations and readiness assessments.
• The Chartis Group: Healthcare-focused advisory firm specializing in payer and provider strategy, transformation, and technology enablement. Closely comparable to ClearCore in its payer transformation focus and boutique consulting model.
• Impact Advisors: Healthcare IT and transformation consulting firm serving health systems and payers on large-scale implementations. Comparable in delivery of readiness, implementation governance, and vendor oversight services.
• ECG Management Consultants: Healthcare-focused consulting firm serving payers and providers on strategy, operations, and technology. Comparable boutique healthcare advisory positioning with payer and provider transformation expertise.
• SullivanCotter: Healthcare-focused consulting firm specializing in payer and provider performance, compensation, and operational strategy. Comparable as a healthcare-specialized boutique consultancy, though narrower in functional focus.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat3 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/clearcore-insights

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 ClearCore Insights