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OperationsPay attention now or pay later. The complexity of Medicare has compelled most of the best-run plans in the country to give the business its own operational platform--- or doing so "virtually," through the careful use of dedicated tools and resources. If any one of your process or tools is not up to standard, then the foundation of your Medicare plan operations is severely compromised. This is true whether your plan performs most functions in house or delegates them to outside vendors. Either way, it's your phone that's going to ring when things go awry. At Gorman Health Group, we maintain the country's largest staff of senior operations consultants. Our team can translate your business strategies into practical, efficient and rigerous work processes with the highest degree of compliance and accountability. Our exposure to many dozens of plans every year mean that we have worked with virtually every software or service vendor in the space. For plans who desire the highest level of transparency and accountability in their operations, we also provide tools to help you monitor your business and make rapid interventions. Product ImplementationThe commitments that one makes to CMS in a product application are non-negotiable -- and form the basis of efficient and compliant operations. Provider Network OperationsGorman Health Group’s Medicare provider network contracting services are designed to help your plan reduce costs and enhance provider relationships. Performance MonitoringOMT™ is a highly-flexible performance monitoring tool that brings actionable performance data to plan leadership in real time. Staff Training and TestingOperations Training and Testing via The Medicare Training Academy. Live and Web-Enabled Training for Your Entire Organization. Medical Management Evaluation and OptimizationWhile much of the organizational attention in today's MA plans is focused on administration, the majority of plan expense (and, should it bear mentioning, the justification for managed Medicare at all) is in the effective coordination of care. Yet for many plans, this vital function has become diffuse and ineffective in recent years. Document Actions |
