Deliver whole-person care models by innovating data analysis for risk assessment, transparent reporting of outcomes, and effective engagement and communication strategies. How We Help Ensure healthcare services are being used appropriately and efficiently with innovative business rules, portal design, and automated authorization workflow processing. We Offer We implement state of the art workflow management tools for auditing and reporting to help meet regulatory requirements and accreditation standards. We Specialize In Partner with Impresiv Health to drive reporting, workflow optimization, and quality improvement initiatives for HEDIS, CAHPS, NCQA, and CMS. We Focus On Implement a clinical model scalable enough to meet the needs of commercial, Medicare, or Medicaid products and sustainable to exceed the ongoing regulatory requirements of CMS, NCQA, and URAC. What We Do We help with the redesign of: Contact us to learn more about our Clinical Service capabilities and expertise. Clinical & Regulatory Guidance
CARE MANAGEMENT
• Innovative/Streamlined Processes
• Real-World Experience
• Structured Workflow Development
• Application of Best Practices
• Holistic Care GuidanceUTILIZATION REVIEW
• Cross-departmental Alignment
• System Configuration Optimization
• Prior Authorization Optimization
• Streamlined Processes
• Elimination of Unnecessary EffortAPPEALS & GRIEVANCES
• Development/Adoption of Standards
• Strengthening Documentation
• Procedure, Process and Workflow design
• Solution Design & Implementation
• Regulatory Reporting StrategiesQUALITY IMPROVEMENT
• Long Term Sustainable Improvement
• Delivering Tangible Results
• Supporting Audit Preparedness
• Development of Policies & Procedures
• Comprehensive Readiness AssessmentsCARE TRANSFORMATION
• Care Management Solution Design & Implementation
• Design strategic roadmaps
• Align Implementations to key initiatives
• Employee Learning & Development
• Execute Rapid Deployment Strategies
• Develop Appropriate Staffing ModelsBUSINESS TRANSFORMATION
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