Who we are
Our team is composed of highly skilled oncology clinicians with diverse backgrounds, including physician assistants, registered nurses, pharmacists, a licensed clinical social worker, and our dedicated oncology and palliative care medical director.
Our purpose
Enhance the quality of cancer care and reduce costs by partnering with Medical Oncology practices to transform care delivery.
We identify care gaps and implement solutions to enhance outcomes for our members, ensuring high-quality treatment and efficient resource utilization.
Cancer care demands a better model — health plans can deliver it
As the leader behind the Carelon oncology solution portfolio, Craig Hunter states,
“The right yes starts with evidence and humanity.”
This philosophy drives Cancer Care Engagement (CCE), part of Carelon’s integrated oncology model, including Oncology Medical Home (OMH). The goal: predictive identification, human connection, and closer partnerships between health plans and providers.
Hunter views embedding CCE as the first step in redesigning the cancer care continuum around patient advocacy and whole-person support.
“That’s what we’re building; embedding CCE as a core part of our oncology solutions is step one,” he said.
“We’ve built our solution around the belief that decisions must be both clinically sound and deeply human,” he said. “Cancer is not a set of codes. It’s a very real journey — one that requires smart navigation and compassionate support.”
- Craig Hunter, Vice President and General Manager of Oncology and Genetics Solutions at Carelon
A better experience is within reach
Oncology Practice Enablement Clinicians (OPECs) equip providers with accessible dashboards and practice-specific metrics. This actionable data empowers practices to reduce variability and promote safer, more effective therapies.
OPECs partner directly with practices — sharing quality metrics, pathway insights, and transformation guidance. This provider enablement strategy strengthens trust, streamlines care coordination, and makes value-based transformation feel not only possible, but welcome. For health plans, the model enhances network engagement, advances value-based strategies, and drives real financial results. But most importantly, it signals a shift away from reactive utilization management toward a proactive, member-centric future.
- Learn more about our CCE program through the lens of Carelon National Oncology Medical Director Dr. David Debono.
- Learn more about Carelon Palliative Care and how they can provide an extra layer of support for your practices.
- Learn more about Care Navigation
- Learn more about Carelon Oncology Treatment Pathway Program
How we directly support Oncology Practices
Cancer Care Engagement
Cancer Care Engagement (CCE) is our solution to improve cancer care. Instead of just managing disease, CCE uses data to find high-risk members early. We connect these individuals with trained oncology navigators who offer personalized support.
These navigators coordinate care, monitor side effects and alert oncology practices on significant symptom changes. They can facilitate fast access to mental health services, palliative care, offer nutrition advice, and help communicate with healthcare teams. We aim to address potential issues before they become emergencies. Our OPEC team educates and guides practices how CCE can provide added support tailored to their needs.
Cancer Treatment Pathways Program
Through this program, Carelon Medical Benefits Management aims to ensure quality care while reducing costs associated with non-evidence-based care. These pathways are developed using a rigorous process that combines evidence-based literature, critical assessment of the medical literature, incorporation of national guidelines and an overall assessment of treatment options based on the value frameworks published by ESMO and ASCO.
Carelon Palliative Care
Carelon Palliative Care offers comprehensive support between doctors’ visits, focusing on physical, emotional, nutritional, and social needs. Our services can begin shortly after diagnosis or at any stage of illness.
• Symptom Management
• 24/7 Support
• In-Home Services
• Caregiver Resources
• Advance Care Planning
• Virtual Services
Carelon Practice Transformation Strategy
The Carelon OPEC team is dedicated to empowering oncology practices on their Practice Transformation journey. Our initiative is centered on advancing patient care, optimizing clinical outcomes, and refining operational efficiency. With our Practice Evaluation Questionnaire, customizable Performance Improvement Plans, and a comprehensive resource library, we are committed to elevating the quality of care and enhancing practice efficiency in partnership with oncology professionals. Discover how we can support your practice today.
Carelon Provider Dashboard
Practices benefit from direct access to customized reports that leverage authorization and claims data, offering valuable insights to enhance the quality and cost-effectiveness of care. The Carelon Provider Dashboard is a collaborative innovation developed by the MBM Analytics, Solutions, and Practice Enablement teams to elevate provider analytics and reporting delivery. Accessible via the Carelon MBM provider portal, the dashboard is bolstered by the expertise and quality assurance of the Carelon Practice Enablement team, working closely with practices to maximize its potential.
Health plans
Health plans benefit from predictable, lower total cost of care.
Care providers
Care providers benefit from advanced analytics and a team of clinician partners to enable success.
Members
Members benefit from personalized care navigation and a better overall experience.
Contact us
Connect with an Oncology Practice Enablement Clinician today to learn more about how our Carelon Oncology Solutions can support your practice.