Having strategic vision and a sound business plan is just the beginning. To succeed in today’s market, healthcare organizations must also be able to implement and execute the granular operational details that make their products run effectively. Gorman Health Group’s operations consultants are expert in translating “big picture” business strategies into concrete action plans that include specific operational procedures and work processes. In addition to leading your plan through all aspects of operational development associated with a new product, GHG provides operational expertise in the following areas:

Finance

  • Business Planning and Financial Modeling for Build versus Buy Decisions
  • Needs Assessments

Enrollment

  • Enrollment and Payment Reconciliations Revenue Optimization and Recovery Initiatives
  • Certification of Plan Enrollment and Encounter Data Validation

Customer Service

  • Development of Workflows, Policies and Procedures, and Desk Reference Manuals
  • Staff Training and Provider Education
  • Member and Provider Call Management System Configuration

CMS Publishes Final 2009 MA Capitation Rates and Part D Payment Policies; CMS Will Conduct Plan Level Audits and Not Make Coding Intensity Adjustments for 2009, 04.10.08
2009 Advance Notice of Capitation Rates, 3.04.08
CMS Call Letter Establishes New Requirements and Reporting Metrics for Plans 1.24.08
Other SNP Sponsors Could Follow In QMed's Wake, Consultant Says; Medicare Advantage News, 11.15.07
The Medicare Outlook: Keys to Success in the New Senior Market, Munich Re America HealthCare Newsletter, 11.01.07
 
Protecting Beneficiaries: Improving & Monitoring Medicare Marketing Practices - AHIP, 05.07
Hard Sell Cited as Insurers Push Plans to Elderly, New York Times, 05.07.07
Advantage Plan's Risk- Wall Street Journal, 04.22.07
Power Shift in Congress Revives Health Debate - New York Times, 01.02.07
 

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