Provider Engagement
… has been awarded three additional certifications from CAQH CORE Operating Rules, formerly known as Phase IV, which includes Prior Authorization and Referrals, Health Care Claims, and Benefit Enrollment, making HealthTrio the only member and provider engagement platform that has achieved this level of interoperability operating standards and data efficiency. “At HealthTrio, we provide real-time solutions certifiably proven to deliver easier, more reliable data sharing and exchange, thereby reducing time …
Print Marc Probst retired this month as chief information officer at Intermountain Healthcare after serving in the role for 17 years and currently serves on the advisory board at SR Health by Solutionreach. It didn’t take long for COVID-19 to highlight some glaring issues in health information technology. Like most businesses globally, healthcare organizations were largely unprepared. We weren’t adequately prepared to move workforces home; quickly shift to virtual …
Georgia Medicare Executive Director - Atlanta, GA - UnitedHealth Group - Atlanta, GA | 7/25/2020
… strategies and initiatives to meet the needs of our members. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion. Primary Responsibilities: Defines and owns execution of the Provider Engagement strategy; establishes strong, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners Defines and owns execution of the Growth and Retention strategy …
Google Alert - Provider | 7/25/2020
… 19. The Chatham long-term care home … Flag as irrelevant Kelly Morgan, MS, CGC, on Findings from the BFOR Trial in Genetic Testing Cancer Network We can report in terms of the primary care provider engagement , a minority of … And less than half of primary care providers opted in to disclosing the … Flag as irrelevant Liz Weston: Free credit score providers use varied formulas, may give different results oregonlive.com Dear …
… stresses caused by the pandemic. “Regardless of what returning to school may look like this year, we know students will need the necessary materials to succeed,” said Kellie Todd Griffin , Senior Director, Community and Provider Engagement , Blue Shield of California Promise Health Plan. “Many families are in need during this difficult time, and we are committed to be a resource by providing backpacks, filled with essential school supplies, to help …
PCC Webinar: The Secret Sauce: How Some Primary Care Practices Are Surviving COVID-19 | 7/23/2020
… IT infrastructure, leadership and governance, and other factors. We learn from the survivors by hearing from leaders at two primary care practices and their health plan counterparts. Speakers: Karolina Skrzypek, MD Medical Director in Provider Engagement , Blue Cross Blue Shield of Michigan Ewa M. Matuszewski CEO and Co-Founder, MedNetOne Health Solutions John Bennett, MD, FACC, FACP President and CEO, Capital District Physicians’ Health Plan (CDPHP) (Albany, N.Y.) Adetutu Adetona …
… which are all built on the company’s Healthcare Map. While Aperture empowers life sciences teams with deep, AI-driven insights to identify and respond to disease burden patterns, Pulse provides alerts that enable optimal provider engagement based on new patient signals. Supplementing these solutions, Prism is a population health analysis software that offers the flexibility to tap into the company’s proprietary Healthcare Map to study and analyze patient cohorts, quickly …
Startup business taxes - USA-NY-Queens | 7/16/2020
Senior Provider Engagement Professional Location : Jersey City, NJ Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance with… Urban Media Website Location : New York City, NY Urban Media Website I’m looking for a urban media website that I can post written & visual content. Site Name : Let’s Keep it a Buck …
New Toolkit Highlights How Medicare Accountable Care Organizations Engage Providers | 7/15/2020
… in the Next Generation ACO Model to identify the strategies that ACOs use to engage health care providers in the ACO and in quality improvement activities. The resulting practices and strategies helped form the Provider Engagement Toolkit , an array of innovative provider engagement strategies that Medicare ACOs use to deliver value-based care. The toolkit includes information on how ACOs: Communicate with providers about the ACO as a value-based …
10 New Solutions to Help Boost Medication Adherence – PM360 | 7/14/2020
… enabling health plans to identify consumers who are at higher risk of medication non-adherence. Leveraging real-time data and a team of nationwide employed licensed clinicians, AdhereHealth provides direct omni-channel consumer and provider engagement to discuss health status, identify resources, coordinate care, and ensure consumers have access to their medication. The program uses data-driven outreach to resolve social determinants of health (SDOH) issues in the context of …
InnovaCare Health Subsidiary MMM Healthcare Celebrates 20th Anniversary | Business Wire | 7/14/2020
… high-quality, affordable care. Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement . Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received …
The 2020 Amwell Client Awards | 7/13/2020
Clinical Impact Cleveland Clinic Cleveland Clinic continues to be a model of provider engagement . With more than 1,000 providers utilizing its Express Care Online platform in 2019 alone, Cleveland Clinic’s commitment to integrating telehealth into the way it delivers care has served as an example for health systems across the country. During the COVID-19 pandemic, the health system saw an unprecedented surge in virtual care. At the height of …
Provider Engagement Toolkit | 7/13/2020
… 4) implement financial incentives. This is the third toolkit in a broader series of resources that explore different aspects of how ACOs operate to provide value-based care. This toolkit highlights an array of provider engagement strategies that Medicare ACOs use to engage health care providers in the ACO and in quality improvement activities. ACOs encourage providers to see the organization as a trusted partner in improving care delivery by …
InnovaCare Health to Cover Smartphone Costs for Dual-Eligible Members | Business Wire | 7/9/2020
… high-quality, affordable care. Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement . Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received …
… and existing patients completely within ProviderMatch. The organization will also leverage the ProviderMatch technology to power a new consumer mobile app it will be launching later this year. “Committed to fostering both consumer and provider engagement , SCL Health recognized what a win-win digital innovation can represent for both those obtaining and providing care when implemented effectively,” said Graham Gardner, MD, CEO of Kyruus. “We’re excited to play a part …
… high-quality, affordable care. Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement . Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received …
… high-quality, affordable care. Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement . Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received …
… developing best-in-class solutions to address the current challenges facing the healthcare industry. “The RSquared Ventures portfolio consisted primarily of technology that focused on improving patient care and communication, reducing overhead, and increasing provider engagement ,” stated Ron Gonzalez, Managing Partner of RSquared Ventures, CEO of UNA Health, and Founder and Former CEO of Prophecy Healthcare. “By combining our resources, we will be able to further this mission to better …
Achieving the Quadruple Aim: Employee Satisfaction in Healthcare | 6/23/2020
… organizations meet their core business objectives. What is the Quadruple Aim? Every health organization is striving for top-quality outcomes for their patients. However, many realize that achieving consistent quality outcomes are tied to provider engagement and satisfaction. The Quadruple Aim was created as an expansion on the Triple Aim of Healthcare. The Triple Aim was focused on improving the health of populations, elevating the patient experience, and reducing the …
… value-based care program, and established the role of data coordinator. Creation of this cross-functional team has aided the development of processes and procedures in areas such as data collection, metrics review and provider engagement . “There’s no way we could achieve success in the program without this team helping ensure we’re managing the project well,” said Lalan Wilfong, M.D., vice president of quality programs and value-based care at …
… flexibility to telecommute as you take on some tough challenges. Primary Responsibilities: Serve as the Relationship Owner for key markets/provider groups in collaboration with Market Leadership. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Partner with business owners to identify methods to execute upon the key strategic visions and then lead the initiative to completion. Collaborate and coordinate …
… driving field based strategies in collaboration with Market Consultation leadership. Primary Responsibilities: Serve as the Relationship Owner for key markets/provider groups in collaboration with Market Leadership. Provide guidance to team members in driving provider engagement and adoption of Optum program and provide recommendations for improvement Partner with business owners to identify methods to execute upon the key strategic visions and then lead the initiative to completion. Collaborate and coordinate …
A guide to pop health IT vendors and SDOH tools | 6/13/2020
… person’s historical data is linked and normalized to create a longitudinal record. The longitudinal record serves as the basis for a broad range of analytic, care and provider performance management applications and patient and provider engagement solutions. Several applications are built on the HealtheIntent platform, including a set of business intelligence and reporting tools with HealtheAnalytics and HealtheEDW; the community care management tool HealtheCare; chronic condition and wellness cohort identification …
A guide to pop health IT vendors and SDOH tools | Healthcare IT News | 6/12/2020
… person’s historical data is linked and normalized to create a longitudinal record. The longitudinal record serves as the basis for a broad range of analytic, care and provider performance management applications and patient and provider engagement solutions. Several applications are built on the HealtheIntent platform, including a set of business intelligence and reporting tools with HealtheAnalytics and HealtheEDW; the community care management tool HealtheCare; chronic condition and wellness cohort identification …
MDH, Office of Prescription Drug Monitoring Program (PDMP), 55 Wade Avenue, Catonsville, MD POSITION DUTIES This position will serve as the PDMP Coordinator of operations, outreach, and engagement for the Prescription Drug Monitoring Program (PDMP) within the Office of Provider Engagement and Regulation’s Office of the PDMP. This position will work with internal and external personnel and with vendors to maintain, track, and report out on program activities, address day …
Medicaid
InnovaCare Health Subsidiary MMM Healthcare Celebrates 20th Anniversary | Business Wire | 7/14/2020
… first and only health plan to receive a 4.5 out of 5-star rating from the Center for Medicare and Medicaid Services (CMS), recognizing the consistency in the quality care MMM’s members receive. Establishing the … distributing risk and developing proprietary technologies to inspire patient and provider engagement. Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more …
Medicare
InnovaCare Health Subsidiary MMM Healthcare Celebrates 20th Anniversary | Business Wire | 7/14/2020
… health plan’s upcoming 20-year anniversary. Since its inception in 2000, MMM has managed the care for more than 720,000 Medicare beneficiaries, with a commitment to make a lasting difference in the health and wellbeing … distributing risk and developing proprietary technologies to inspire patient and provider engagement. Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more …
Centers for Medicare and Medicaid Services
InnovaCare Health Subsidiary MMM Healthcare Celebrates 20th Anniversary | Business Wire | 7/14/2020
… care. Today, we are the only plan with a 4.5-star rating, out of a total of 5, in the Centers for Medicare and Medicaid Services program. Therefore, the well-being and satisfaction of our … distributing risk and developing proprietary technologies to inspire patient and provider engagement. Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more …
Population Health
… Population Health and Quality Transformation. “To continue being a market leader in sharing more data throughout our network, we are proud to partner with BHI and use their cutting-edge analytics tools to reinvent our provider reports, making them more useful to providers. This partnership represents our commitment to and investment in provider engagement. The reports will advance our work with provider partners around the state to drive meaningful changes …
ACO
CareMount’s Foundation for Accountable Care Organization Savings | RevCycle Intelligence | 6/4/2020
… care organization Source: Getty Images By June 04, 2020 - In CareMount Health Solutions’ first year as an accountable care organization (ACO) in Medicare’s Next General ACO Model, the organization was one of 38 participants to … communication, and physician alignment and engagement. Data and analytics Alongside provider engagement and care management, IT and data analytics make up the three cogs helping providers succeed in the Next Generation ACO Model, according to …
ACOs
CareMount’s Foundation for Accountable Care Organization Savings | RevCycle Intelligence | 6/4/2020
… blocks for success: data and analytics, care coordination infrastructure, patient communication, and physician alignment and engagement. Data and analytics Alongside provider engagement and care management, IT and data analytics make up the three cogs helping … and care teams at the point of care.” Next Generation ACOs have a legacy of leveraging data and analytics tools to complete value-adding tasks, such as identifying gaps in care, improving care transitions, and …
Patient Satisfaction
… patient satisfaction and provider engagement. The CMO is responsible for developing and leading a high performing, scaled provider organization spanning Long Island and the boroughs of New York City. The CMO will be responsible for introducing innovative new services across the platform, be an effective change agent, be able to gain followership from the provider organization and work with payer partners to address their members’ needs. The CMO will represent …
Behavioral Health
PHILADELPHIA , Jan. 7, 2020 /PRNewswire/ – Tridiuum , the leading digital behavioral health company for improving outcomes, access, and patient-provider engagement across integrated care environments, today announced that LifeStance Health , a national leader in behavioral healthcare services, has selected the Tridiuum ONE platform to drive improvements in patient outcomes, further enhance quality, and better demonstrate the value of its services to patients, providers, and purchasers. Both companies also view the relationship …
Mental Health
PHILADELPHIA , Jan. 7, 2020 /PRNewswire/ – Tridiuum , the leading digital behavioral health company for improving outcomes, access, and patient-provider engagement across integrated care environments, today announced that LifeStance Health , a national leader in behavioral healthcare … support LifeStance in the essential work they do to treat mental health issues across the country – particularly as it relates to ending the suicide epidemic,” said Mark Redlus , Tridiuum CEO. “With demand for mental health …
Digital Health
PHILADELPHIA , Jan. 7, 2020 /PRNewswire/ – Tridiuum , the leading digital behavioral health company for improving outcomes, access, and patient-provider engagement across integrated care environments, today announced that LifeStance Health , a national leader in behavioral healthcare … it a step further, advancing behavioral treatment progress. The company’s digital health platform, Tridiuum ONE, combines nearly 20 years of behavioral health research and clinical expertise with technical fluency. It is proven to identify behavioral …
Digital Behavioral Health
PHILADELPHIA , Jan. 7, 2020 /PRNewswire/ – Tridiuum , the leading digital behavioral health company for improving outcomes, access, and patient-provider engagement across integrated care environments, today announced that LifeStance Health , a national leader in behavioral healthcare services, has selected the Tridiuum ONE platform to drive improvements in patient outcomes, further enhance quality, and better demonstrate the value of its services to patients, providers, and purchasers. Both companies also view the relationship …
Behavioral Health Outcomes
PHILADELPHIA , Jan. 7, 2020 /PRNewswire/ – Tridiuum , the leading digital behavioral health company for improving outcomes, access, and patient-provider engagement across integrated care environments, today announced that LifeStance Health , a national leader in behavioral healthcare services, has selected the Tridiuum ONE platform to drive improvements in patient outcomes, further enhance quality, and better demonstrate the value of its services to patients, providers, and purchasers. Both companies also view the relationship …
Health Management
BOSTON Health Vector , a health management app that activates a patient decision support system enabling patient engagement and health literacy to improve health outcomes and lower costs for employers and payors, announced today the release … report on health and lifestyle data for improved patient-to-provider engagement. The patient-generated health data combined with clinical data facilitates a patient decision support system to help drive better health literacy and improve …
Clinical Data
… provider engagement. The patient-generated health data combined with clinical data facilitates a patient decision support system to help drive better health literacy and improve outcomes. Innovative quizzes and the Health IQ score enable users to be informed and stay on track. Contextualized and personalized insights and reports prepare users for meaningful engagement with healthcare providers. Custom analytics tools enable employers and payors with a first-of-its-kind population …
Patient Engagement
BOSTON Health Vector , a health management app that activates a patient decision support system enabling patient engagement and health literacy to improve health outcomes and lower costs for employers and payors, announced today the release … report on health and lifestyle data for improved patient-to-provider engagement. The patient-generated health data combined with clinical data facilitates a patient decision support system to help drive better health literacy and improve …
Employee Engagement
… for patient health management; and a Health IQ score and innovative health quizzes to bolster health literacy and drive sustained employee engagement. All found on one user-friendly interface, the technology supports diagnostic accuracy and … report on health and lifestyle data for improved patient-to-provider engagement. The patient-generated health data combined with clinical data facilitates a patient decision support system to help drive better health literacy and improve …
Clinical Decision Support
MedCurrent Partners with openDoctor to Enable Seamless Radiology Clinical Decision Support for Ordering Providers Share Article Ordering providers using the openDoctor platform will now have an easy way to meet the PAMA mandate for the … with openDoctor, a leader in patient scheduling automation and referring provider engagement technology. As a result, MedCurrent’s OrderWise® CDS solution will be integrated into openDoctor’s physician engagement platform to give ordering providers a seamless way …
Utilization Management
… Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics Vendors Clinical Analytics Vendors Technology-enabled Services Vendors Vendors to Watch Chilmark Bearing - Healthcare Payer Analytics Vendor Letter Grades Detailed Vendor Ratings Product Capabilities Ratings Vendor Product Capabilities Ratings Market Execution Ratings Vendor Market Execution Ratings VENDOR …
Advanced Analytics
… fraud, waste and abuse, and controlling the total cost of care and identifying cost drivers. Payers are also turning to advanced analytics to predict a range of outcomes, costs, and events. However, capitalizing on the … Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics Vendors Clinical Analytics Vendors Technology-enabled Services Vendors Vendors to …
Member Engagement
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … intervention success and promoting member satisfaction Create a data-driven member engagement strategy to maximize resources Measure and continually monitor interventions to see if they are impactful Lung’s passion to improve the quality of health …
AHIP
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by Nov 19, 2019, 18:28 ET Share this article DALLAS , Nov. 19, 2019 /PRNewswire/ – HealthMine’s COO, Amy Lung , a nationally-recognized expert on member driven quality improvement strategies, will be conducting an AHIP Webinar on November …
NCQA
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … achieving and sustaining 4.0 Star Ratings in Medicare Advantage, 4.0 NCQA Medicaid Health Plan Ratings for top-rated Medicaid Plan Performance and capturing significant revenue return in Medicaid Withhold Programs. Our goal is to provide …
Medicare Advantage
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … several organizations - in achieving and sustaining 4.0 Star Ratings in Medicare Advantage, 4.0 NCQA Medicaid Health Plan Ratings for top-rated Medicaid Plan Performance and capturing significant revenue return in Medicaid Withhold Programs. Our goal …
Value-Based Insurance
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by … satisfaction. Its powerful intelligence platform was originally built inside a Value-Based Insurance Design (VBID) health plan— designed to aggregate data and utilize advanced algorithms to combine population health and quality improvement disciplines to help …
Provider Performance
… part of Veradigm™, an Allscripts (NASDAQ: MDRX) business unit. This year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on … intelligence tools offer real-time visibility into member behavior and provider performance. Pulse8’s Illumin8 Active Intelligence™ platform offers a suite of uniquely pragmatic solutions that are powered by our patent-pending Dynamic Intervention Planning …
Komodo Health
Komodo Health provides a powerful spectrum of data analysis software to cross-link the patient’s care pathway data with other medical and healthcare datasets to better understand and predict disease SANTA CLARA, Calif. Based on … to disease burden patterns, Pulse provides alerts that enable optimal provider engagement based on new patient signals. Supplementing these solutions, Prism is a population health analysis software that offers the flexibility to tap into the …
Cerner
A guide to pop health IT vendors and SDOH tools | Healthcare IT News | 6/12/2020
… Healthcare IT News is compiling this comprehensive special report detailing the vendors in this space. This list will be updated. Cerner Cerner’s EHR-agnostic insights platform HealtheIntent helps health systems and other provider organizations create … analytic, care and provider performance management applications and patient and provider engagement solutions. Several applications are built on the HealtheIntent platform, including a set of business intelligence and reporting tools with HealtheAnalytics and HealtheEDW; the …
NaviNet
… customer-focused health maintenance organization, to increase operating efficiency, lower costs and improve provider satisfaction via the full suite of NaviNet® Open Multi-Payer Portal applications. The Health Plan is one of the largest locally … of the partnership, NaviNet Open will drive The Health Plan’s provider engagement strategy through the NaviNet Open portal, comprised of Eligibility and Benefits, Claims Status Inquiry, Claims Management, Authorizations, Referrals and Document Exchange. The portal …
HealthEC
… Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics Vendors Clinical Analytics Vendors Technology-enabled Services Vendors Vendors to Watch Chilmark Bearing - Healthcare Payer Analytics Vendor Letter Grades Detailed Vendor Ratings Product Capabilities Ratings Vendor Product Capabilities Ratings Market Execution Ratings Vendor Market Execution Ratings VENDOR PROFILES Arcadia.io CareEvolution Cerner Corporation Certilytics, Inc Change Healthcare Clarify Health Solutions Cotiviti Health Catalyst HealthEC IBM Watson …
ZeOmega
… Cost and Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics … Health MedeAnalytics Medecision Milliman Optum Philips SCIO-EXL SPH Analytics ZeOmega TABLES AND FIGURES CHAPTER 1: EXECUTIVE SUMMARY Figure 1.1: Payer Analytics Vendors and Vendor Types CHAPTER 2: PAYER ANALYTICS TECHNOLOGIES AND APPLICATIONS Table 2.1 …
Medecision
… Cost and Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics … Health Solutions Cotiviti Health Catalyst HealthEC IBM Watson Health MedeAnalytics Medecision Milliman Optum Philips SCIO-EXL SPH Analytics ZeOmega TABLES AND FIGURES CHAPTER 1: EXECUTIVE SUMMARY Figure 1.1: Payer Analytics Vendors and Vendor Types CHAPTER …
Optum
… Cost and Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics … Cotiviti Health Catalyst HealthEC IBM Watson Health MedeAnalytics Medecision Milliman Optum Philips SCIO-EXL SPH Analytics ZeOmega TABLES AND FIGURES CHAPTER 1: EXECUTIVE SUMMARY Figure 1.1: Payer Analytics Vendors and Vendor Types CHAPTER 2: PAYER …
HealthMine
HealthMine COO Amy Lung– a Nationally-Recognized Expert on Member Driven and Provider Engagement Strategies– to Conduct AHIP Webinar on November 21st Webinar entitled: Continuous Health Action Engagement to Maximize Quality Improvement News provided by Nov 19, 2019, 18:28 ET Share this article DALLAS , Nov. 19, 2019 /PRNewswire/ – HealthMine’s COO, Amy Lung , a nationally-recognized expert on member driven quality improvement strategies, will be conducting an AHIP Webinar on November …
UnitedHealth Group
Quality Assurance Auditor - Telecommute - UnitedHealth Group - Minneapolis, MN | 11/14/2019
… and various initiatives related to Risk Adjustment are implemented. Improvement will occur through internal and external education, innovative programs and provider engagement. Perform all other related duties as assigned. The minimum productivity goal is set … telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, meet or exceed all performance expectations Preferred Qualifications: Bachelor’s …
UnitedHealth
Quality Assurance Auditor - Telecommute - UnitedHealth Group - Minneapolis, MN | 11/14/2019
… and various initiatives related to Risk Adjustment are implemented. Improvement will occur through internal and external education, innovative programs and provider engagement. Perform all other related duties as assigned. The minimum productivity goal is set … telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, meet or exceed all performance expectations Preferred Qualifications: Bachelor’s …
Allscripts
… Allscripts (NASDAQ: MDRX) business unit. This year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on Wednesday, November 13 th , from 11:30am - 12:30pm MST at the Fairmont Scottsdale Princess in Scottsdale, Arizona. During this panel, attendees will learn how to: Consider new and innovative ways to fight off provider and member fatigue and come away …
Pulse8
Pulse8 Presenting as a Panelist on Provider-Health Plan Relationships During the RISE Risk Adjustment Forum in Scottsdale, AZ Download Thumbnail November 11, 2019 08:01 AM Eastern Standard Time CHICAGO–( BUSINESS WIRE )–In its 14 … year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on Wednesday, November 13 th , from 11:30am - 12:30pm MST at the …
Veradigm
… Veradigm™, an Allscripts (NASDAQ: MDRX) business unit. This year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on Wednesday, November 13 th , from 11:30am - 12:30pm MST at the Fairmont Scottsdale Princess in Scottsdale, Arizona. During this panel, attendees will learn how to: Consider new and innovative ways to fight off provider and member fatigue and …
Clinical Insights
… part of Veradigm™, an Allscripts (NASDAQ: MDRX) business unit. This year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on … integrated data systems and services business that combines data-driven clinical insights with actionable tools for clinical workflow, research, analytics, and media. Our solutions are designed to help key healthcare stakeholders to improve the quality …
Innovaccer
… multiple areas such as closing quality care gaps; managing care transitions, complex care and ED avoidance; and managing pharmacy needs.” Provider engagement also was a key strategy and included the establishment of a clinically integrated … Elekta, Enli Health Intelligence, Epic, GSI Health, Health Catalyst, HealthEC, Innovaccer, MAP Health Management, Medicity, NextGen Healthcare, Optum, Orion Health, Varian Medical Systems and ZeOmega. MEETING THE CHALLENGE In partnership with Lumeris, LCMC Health established …
Anthem, Inc.
Provider Performance Medical Director - Payment Innovation - Nationwide - PS28124Location: United StatesRequisition : PS28124Post Date: 20 hours agoYour Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to … Any Anthem location or remote)This physician will focus on provider engagement and achieving performance results in value based care reimbursement models across lines of business in multiple markets. This role will bring insight, innovation …
Casenet
Security Health Plan Selects Casenet’s Population Health Management Platform | PRWeb | 8/27/2019
Casenet® LLC today announced that Security Health Plan of Wisconsin, Inc., has selected TruCare , Casenet’s population health management platform, to support their care management and population health initiatives. Security Health Plan is a Wisconsin-based … ProAuth, a digital authorization tool to support Security Health Plan’s provider engagement strategy; TruCare GuidedCare, assessments and care plans Informed by MCG for Disease Management which supports evidence-based clinical decision-making for chronic conditions …
Aktana
Assistive Technologies 66 Views Patient-Level Insights from 15 Million Daily Clinical Encounters Are Delivered Directly to Commercial Teams to Enhance Decision-Making at the Time of Provider Engagement Aktana , a pioneer in AI-enabled decision support for global life science companies, and Komodo Health, the healthcare AI company that’s built the most complete map of patient journeys in the US, today announce a new partnership to offer a prebuilt …
Beacon Health Options
Beacon Health Options Names Michael Ramseier as West Region Market President News provided by Oct 11, 2017, 10:30 BOSTON , Oct. 11, Beacon Health Options (Beacon), a national leader in behavioral health management, announced today that … regulatory compliance and policy. Mr. Ramseier previously was Vice President, Provider Engagement and Contracting, West Region for Anthem Blue Cross, California , where he was responsible for the development and implementation of industry-leading health care …
LifePoint Health
EVOQ Medical Names Long-Time Studer Group Leader as CEO | PR Newswire | 10/23/2017
… the VA reform law that same year. Prior to joining Studer Group in 2004, Collard was a healthcare operator at LifePoint Health where he helped effect three consecutive turnarounds. “In my work with clients, I … creates solutions for the healthcare industry, focusing on improving health provider engagement. Its flagship product, blynq, is a mobile platform consolidating electronic health record data from multiple systems and creating a longitudinal patient record giving …
EVOQ Medical Names Long-Time Studer Group Leader as CEO | PR Newswire | 10/23/2017
… the VA reform law that same year. Prior to joining Studer Group in 2004, Collard was a healthcare operator at LifePoint Health where he helped effect three consecutive turnarounds. “In my work with clients, I … creates solutions for the healthcare industry, focusing on improving health provider engagement. Its flagship product, blynq, is a mobile platform consolidating electronic health record data from multiple systems and creating a longitudinal patient record giving …
Molina Healthcare
Molina Healthcare Waives COVID-19 Testing Costs for Members | Business Wire | 3/7/2020
LONG BEACH, Calif.- Molina Healthcare today announced it is waiving all member costs associated with testing for the Coronavirus, which causes COVID-19. “Due to Molina’s focus on vulnerable and underserved populations, we want to … providers, and government partners. “We are diligently working with our provider engagement teams to share information with Molina’s provider community about coverage and testing for members,” said Dr. Dees. “If a member develops symptoms associated …
Molina Healthcare Waives COVID-19 Testing Costs for Members | Business Wire | 3/7/2020
LONG BEACH, Calif.–(BUSINESS WIRE)–Mar 6, 2020– Molina Healthcare today announced it is waiving all member costs associated with testing for the Coronavirus, which causes COVID-19. “Due to Molina’s focus on vulnerable and … providers, and government partners. “We are diligently working with our provider engagement teams to share information with Molina’s provider community about coverage and testing for members,” said Dr. Dees. “If a member develops symptoms associated …
Affinity Health Plan
Job Detail for Account Manager - Provider Relations (Bilingual-Mandarin and/or Cantonese) - New York Job Location: Affinity Health Plan, New York, NY, , USA Job Detail for Account Manager - Provider Relations (Bilingual-Mandarin and/or Cantonese … the preferred plan through superior customer service and execution of provider engagement strategies.Seeking Network Account Managers committed to developing and managing a high performance network and engaging in various provider engagement strategies that follow four …
… Affinity Health Plan, Bronx, NY, Account Manager - Provider Relations (Bilingual-Mandarin and/or Canton Job Location: Affinity Health Plan, Bronx, NY, , USA Jobs In Account Manager Provider Rela… Jobs In Account Manage… Jobs In Account M… PURPOSE OF THE POSITION:Represent and advance Affinity Health Plan interests in the provider market as the preferred plan through superior customer service and execution of provider engagement strategies.Seeking Network Account Managers committed to …
Humana
(USA-DE-Dover) Senior Provider Engagement Professional | 10/30/2019
Humana Senior Provider Engagement Professional in Dover , Delaware Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth …
Job Detail for Provider Engagement, Clinical Professional 2 Job Location: Humana, New York, NY, , USA Job Detail for Provider Engagement, Clinical Professional 2 Job Location: Humana, New York, NY, , USA Jobs In Provider Engagement Clinical … Jobs In Provider Engag… Jobs In Provider … Description The Provider Engagement, Clinical Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and …
UnitedHealthcare
… provider engagement and clinical implementation and advancement of the UnitedHealthcare (UHC) Individual Health Record (IHR) across the regional Accountable Care (AC) program and business teams as the AC Regional Clinical Deployment Lead. + Leads the clinical activation and advancement of the IHR across other populations beyond ACs + Deliver Practice-facing training and refresher training on all AC Clinical Technology Solutions + Tie-in IHR and existing technology solutions to 6 (Pillars) Essentials …
… provider engagement and clinical implementation and advancement of the UnitedHealthcare (UHC) Individual Health Record (IHR) across the regional Accountable Care (AC) program and business teams as the AC Regional Clinical Deployment Lead. + Leads the clinical activation and advancement of the IHR across other populations beyond ACs + Deliver Practice-facing training and refresher training on all AC Clinical Technology Solutions + Tie-in IHR and existing technology solutions to 6 (Pillars) Essentials …
Anthem Blue Cross
In late August, Portland-based MaineHealth announced plans to create a joint venture with Anthem Blue Cross and Blue Shield of Maine. Through the joint venture, called AMH Health, MaineHealth and Anthem plan to sell … collaborate with Anthem on the development of population health strategies, provider engagement, alignment, collaboration and transparency. Together we have focused on building a partnership that has required a lot of due diligence and work with …
Qualidigm Names Anthem Blue Cross and Blue Shield of Connecticut President and General Manager Jill Hummel to its Board of Directors Share Article Jill Hummel, president and general manager of Anthem Blue Cross and Blue … health care. She joined Anthem in 2007 as vice president, provider engagement and contracting for Anthem’s Northeast markets. Hummel earned a Juris Doctor from Washington University and a Bachelor of Arts degree from the University …
Cigna
… with each other, making it easier to sort through discrepancies, said Dr. Leslie McKinney, lead medical director for value-based provider engagement at the Blues plan. “We’re learning from each other and iterating as we … imposed on them, he said. Collegiality Bloomfield, Conn.-based insurer Cigna has acknowledged that not all the measures it uses for value-based contracts will be relevant to providers, so it has established a minimum …
HOUSTON–(BUSINESS WIRE)–Aug 20, 2019– CareAllies, a Cigna (NYSE: CI) company, was named the top-rated Value-Based Care (VBC) Consultant for Physician Practices for a second consecutive year by Black Book Market Research … people they serve,” said Beckie Croes, senior vice president of provider engagement and management services, CareAllies. “We earned this top-rating from providers for the second consecutive year because we are delivering differentiated value for …
Aetna
… with each other, making it easier to sort through discrepancies, said Dr. Leslie McKinney, lead medical director for value-based provider engagement at the Blues plan. “We’re learning from each other and iterating as we … The network is in value-based payment contracts with UnitedHealthcare, Aetna and other large commercial payers. Crow said sections of data reports from insurers are left blank because they can’t disclose the total cost of …
Data Scientist Lead - Aetna - Wellesley, MA | 8/23/2019
Share Description Description: Aetna’s Consumer Health Services - Clinical Analytics team is seeking a Data Scientist to develop advanced analytic insights to drive new programs and initiatives to improve health outcomes and reduce health care costs … insights to develop and test solutions that improve consumer and provider engagement, health outcomes and lower health care costs. 63078 Fundamental Components: This position is a unique opportunity for someone passionate about applying innovations in …
Laura Wood
… Cost and Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics … focused, comprehensive and tailored research. Media Contact: Research and Markets Laura Wood , Senior Manager [email protected] For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 …
… Cost and Utilization Management Quality Management Care Management Risk Management Payment Management Predictive Analytics Value-based Healthcare Network Optimization and Provider Engagement Market Expansion CHAPTER 3: PAYER ANALYTICS VENDORS Vendor Types Inclusion Criteria Claims Analytics … focused, comprehensive and tailored research. Media Contact: Research and Markets Laura Wood , Senior Manager [email protected] For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 …
Peter Masanotti
Security Health Plan Selects Casenet’s Population Health Management Platform | PRWeb | 8/27/2019
… TruCare, the flagship care management and utilization management platform; TruCare ProAuth, a digital authorization tool to support Security Health Plan’s provider engagement strategy; TruCare GuidedCare, assessments and care plans Informed by MCG for Disease Management … to improve the quality of care for their members,” said Peter Masanotti, CEO of Casenet. “The TruCare platform will create workflow efficiencies and help Security Health Plan target members who will benefit the most from …
… release of TruCare® 6.4. This new release improves and expands upon existing functionality while also introducing new features to improve provider engagement, member communications and compliance with regulatory requirements while reducing costs. TruCare 6.4 also … improved ways to engage members and providers are essential,” stated Peter Masanotti, chief executive officer, Casenet. “By continuing to listen and partner with our clients, we are able to enhance our leading-edge platform to …
Michael Ramseier
Beacon Health Options Names Michael Ramseier as West Region Market President News provided by Oct 11, 2017, 10:30 BOSTON , Oct. 11, Beacon Health Options (Beacon), a national leader in behavioral health management, announced today that … regulatory compliance and policy. Mr. Ramseier previously was Vice President, Provider Engagement and Contracting, West Region for Anthem Blue Cross, California , where he was responsible for the development and implementation of industry-leading health care …
Beacon Health Options Names Michael Ramseier as West Region Market President | CNBC | 10/11/2017
… network contracting, provider relations, clinical management, client services, sales, product development, and underwriting functions for group and individual business, as well as commercial regulatory compliance and policy. Mr. Ramseier previously was Vice President, Provider Engagement and Contracting, West Region for Anthem Blue Cross, California, where he was responsible for the development and implementation of industry-leading health care delivery and reimbursement models. He began his career in managed care with …
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