Medical Management Experts.
STAFF AUGMENTATION
Short term clinical and administrative leadership, management and operational support of essential health plan functions, such as Utilization Management, Physician Review, Case Management, Quality Improvement/Assurance, Accreditation and overall plan leadership.
Senior Leadership: CMO, COO, CFO, CCO
Physician Advisory Services: Medical necessity review & program oversight
Clinical Management: VP, Director, Manager, Medical Director
Front-Line Operators: Nurses, Physicians, Behavioral Health Clinicians (RN, LPN, LCSW, LMFT, MD/DO, etc.)
Quality, Compliance and Accreditation: Professional experts to lead/execute initiatives
We provide ongoing operational infrastructure and oversight to managed care organizations over extended periods, typically 4-6 months, but as short or long as needed. This customizable approach ensures health plan leadership continuity and operational continuity while recruiting efforts for permanent placements take place.
Our consultants, through years of hands-on experience, possess an in-depth understanding of the issues that impact performance and organizational success across the spectrum of health care services (e.g., QI, UM, CM, etc.) and population types (Medicare Advantage, Medicaid, Special Needs, Commercial).
Our physician advisors are highly experienced in managed care and provide a range of medical and behavioral physician review services, care management program oversight, and CMO/medical director leadership.
Recognizing the challenges that an organization can experience during times of turnover within leadership or front-line operations, or when there is a need for rapid responses to market/enterprise changes, we deploy our staff for specific, individual assignments or as teams.
Engagement examples include:
- Senior medical director for medical utilization management physician review
- Accreditation expert to guide NCQA initial accreditation
- Medical utilization management RNs to support a Medicaid expansion
- Quality Improvement director and Interim Staff for Behavioral Health Utilization Management and Case Management (LCSWs, Psych RN)
- Interim Chief Medical Officer
- Case and Utilization Management clinicians to support rapid Medicaid growth due to COVID-19
If you have a need, we can help. Please contact us.
