Consulting

The principals of U.S. Care Management have years of experience in health plan, integrated delivery organization, hospital, and physician practice management.

Our staff is experienced in Commercial, Medicaid and Medicare programs. We can work with you to improve your health services department with services such as preauthorization, utilization management, case management, quality improvement, data analysis, contract and rate analysis including capitation, as well as ensure compliance with NCQA and other surveying organizations.

Examples of some of USCM’s consulting work: 

• Assisting an HMO with Department of Health Issues and operational performance. Reviewing the operations of the medical services department of a TPA, developing appropriate Policies and Procedures, reports, training staff and assisting with identifying and hiring staff.
• Writing an HMO application and developing all start-up Policies and Procedures.
• Developing a National Directory of Rural HIV/AIDS providers.
• Analyzing two years of state Medicaid claims data on over 600,000 Medicaid lives to determine chronic illness incidence and costs.