New intelligence platform brings AI applications, customer-approved models and unified member data directly into utilization and care management workflows
PLANO, TX / ACCESS Newswire / October 20, 2026 / ZeOmega, the industry's leading population health management organization, today announced the launch of Jiva PrudenceAI, an AI intelligence and orchestration platform for health plans and other risk-bearing organizations. Jiva PrudenceAI adds an intelligence layer over healthcare management platforms, including Jiva, delivering summaries, recommendations, and prepared actions inside the workflows utilization management (UM) and care management (CM) teams already use. Built-in governance controls which AI models run, what each one can do, how outputs are validated, and when clinicians review decisions.
Health plans face growing authorization volumes, mounting care manager workloads, and rising expectations from members, providers, and regulators, all while being asked to do more with the same resources. AI holds promise to relieve that pressure, but too often it arrives as a disconnected tool working from incomplete data, with little visibility into how its recommendations are made.
Jiva PrudenceAI is designed to close that gap by bringing data, intelligence, and governance together where work actually gets done. By automating manual work, it accelerates decisions and expands staff capacity, helping reduce the cost of each prior authorization, shorten turnaround times, and ease the documentation burden behind care manager overtime and attrition.
"Health plans don't need to migrate platforms to put AI to work. They need an AI foundation they can trust and without being forced to investing in new AI native platforms," said Sam Rangaswamy, CEO, ZeOmega. "For more than two decades, we have supported health plans' clinical records and care operations, and Jiva PrudenceAI builds on that experience. Plans can use AI from ZeOmega, their own models, or a certified partner, all under the same controls. That combination of intelligence and governance is what payers are asking for right now."
Key Jiva PrudenceAI capabilities include:
- Prior authorization support: Smart UM automates authorization intake, including faxes, and assists reviewers with medical guidelines, digitized health plan policies, and decision support.
- Care management support: Prepares care managers for member calls, summarizes calls and clinical information, recommends assessments, and drafts care plans.
- A complete view of each member: The Jiva Data Fabric brings together clinical, operational, administrative, and external data, along with risk scores, chronic conditions, and case context for real time risk stratification analysis and a real-time view of each member. It runs on a hybrid cloud lakehouse.
- Oversight of every AI action: Logs, explains, and can halt any AI-driven decision in real time, with full audit trails and human review. Member health information remains within ZeOmega's secure environment.
- Flexibility to add AI: Health plans can choose ready-to-use applications from ZeOmega's catalog, connect their own approved AI models through bring-your-own-AI (BYoAI) interfaces, or integrate tools from ZeOmega's certified partners.
ZeOmega's approach to AI governance has been independently validated. In July 2026, the company earned Artificial Intelligence Accreditation from DirectTrust, which recognizes AI governance, risk management, and oversight practices aligned with the National Institute of Standards and Technology (NIST) AI Risk Management Framework.
"In healthcare, it is not about the latest model. It is about the trusted one," said Jeff Rush, Chief AI Officer, ZeOmega. "We built Jiva PrudenceAI so that every AI action, no matter which model produced it, runs under the same policies, the same validation, and the same human review. Governance is not a feature we added on top of the product, it is the architecture the product was built on."
Jiva PrudenceAI is available now. Health plans can deploy it alongside the utilization and care management systems already in use, without switching platforms, and existing ZeOmega Jiva clients can activate it directly. To learn more or request a demo, visit Jiva PrudenceAI: AI Orchestration for Health Plans | ZeOmega or contact sales@zeomega.com.
About ZeOmega
ZeOmega empowers health plans and other risk-bearing organizations with the industry's leading technology for simplifying population health management. Clients using ZeOmega's Jiva Healthcare Enterprise Management Platform experience superior workflow and proven results due to exceptional integration capabilities, unmatched clinical content, and a powerful rules engine. With deep domain expertise and a comprehensive understanding of population health challenges, ZeOmega serves as a true partner for clients with personalized deployment and delivery models. By consistently exceeding customer expectations and project benchmarks, ZeOmega has earned a reputation for being proactive, reliable, and dedicated to improving the health of its clients' members. ZeOmega was named Best in KLAS for Payer Care Management Solutions in 2022, 2023, 2024, and 2025. Founded in 2001, ZeOmega is privately held and headquartered in Plano, Texas.
ZeOmega and Jiva are registered trademarks or trademarks of ZeOmega, Inc. or its subsidiaries in the United States and other countries. Other marks or brands may be claimed as the property of others.
Media Contact:
Karina Stabile
Aria Marketing for ZeOmega
KStabile@ariamarketing.com
SOURCE: ZeOmega
View the original press release on ACCESS Newswire:
https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/zeomega-launches-jiva-prudenceai-to-embed-governed-ai-in-daily-health-1238881
