Utilization Management Metrics and Benchmarks

Event Date: 11/10/2017

Event Overview

Friday, November 10, 2017
1:00 CT – 2:00 CT (60 minutes)

Session description: 

As a follow up to a recent request for further conversation on this topic via the discussion forum, Linda Dickinson, RN Director of Medical Resource and Quality Management at Physician's Health Plan of Mid-Michigan will kick off a discussion around Utilization Management metrics and benchmarks plans have in place to monitor operational performance and  early indicators of medical expense issues.   Please come prepared to share how you are addressing within your plan and join the conversation.

The format will be an open discussion.   

This event is designed for:

Staff, managers and executives who work in Utilization Management and other related administrative areas.

This event is hosted on our Readytalk platform.

Other events you might find of interest:

  • Webinar | December 12, 2017 | Disease Management Roundtable| Click here
Documents
  • 11/16/2017
  • Podcast: Utilization Management Metrics and Benchmarks
  • As a follow up to a recent request for further conversation on this topic via the discussion forum, Linda Dickinson, RN Director of Medical Resource and Quality Management at Physician's Health Plan of Mid-Michigan will kick off a discussion around Utilization Management metrics and benchmarks plans have in place to monitor operational performance and early indicators of medical expense issues.
Attendees

Below is a list of all delegates registered to date for this event

  • Barbara Guerard
  • ALLIANCE GUEST
  • Senior Vice President - Health Services at Peoples Health
  • Caroline Abeleda
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Operations at Indiana University Health Plans
  • Tashau Asefaw
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Care Coordination and Community Linkages at Community Health Plan of Washington
  • Kevin Attride
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Regional AVP, Network Strategies at Adventist Health Plan
  • Anita Baker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, UM at Avera Health Plans
  • Mark Bean
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Healthcare Actuary at Community Health Plan of Washington
  • Susan Bearden
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Case Management at AvMed
  • Ira Bell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Medical Director at FirstCare Health Plans
  • Barbara Berger
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Care Management Services at FirstCare Health Plans
  • Dorothy Bookhultz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Quality Management Nurse at Johns Hopkins HealthCare
  • Pat Bremer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Decision Support Services at Paramount Health Care
  • Danielle Brinkley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Population Analytics at Community Health Plan of Washington
  • Roger Combs
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director - IT at Health Alliance Plan
  • Julie Combs Warner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Health Services at SelectHealth
  • Abigail Corner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Consultative Solutions at Health Alliance Medical Plans
  • Michael Cutroni
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Interim VP, Healthcare Affordability at Health Alliance Plan
  • Paula Davis
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Director, Program Integrity at Indiana University Health Plans
  • Cynthia Davis
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Care Management at FirstCare Health Plans
  • Sarah Dencker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Utilization Management, Appeals & Grievance at Network Health Plan
  • Joy Denzak
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Medical Management at Fidelis Care New York
  • Kristi DePriest
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Medical Management at Samaritan Health Plans
  • Linda Dickinson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Medical Resource and Quality Management at Physicians Health Plan
  • David DiGiuseppe
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP of Healthcare Economics at Community Health Plan of Washington
  • Charles DiValerio
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager-Analytics at Prominence Health Plan
  • Jay Dodson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Project Manager at Indiana University Health Plans
  • Mike Dooley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Provider Contracting & Engagement at Avera Health Plans
  • Amy Edge
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • UM Acute Care Team Lead at Paramount Health Care
  • Jenifer Elinski
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager at Health Alliance Plan
  • Margaret Erdman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Actuarial Analyst at Geisinger Health Plan
  • Sharon Espinosa
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Medical Management at Quartz Health Solutions
  • John Ferrell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Customer Service Supervisor at Community Health Plan of Washington
  • Alice Frank
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr Healthcare Informatics Analyst at Quartz Health Solutions
  • Kathy Garcia
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Unknown at Presbyterian Healthcare Services
  • Cynthia Hadley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • EDW Analyst at Health First Health Plans
  • Steven Harber
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Finance Analyst at MetroPlus Health Plan
  • Sarah Harbin
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Utilization Management at Health Alliance Medical Plans
  • Courtney Hawk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Manager at Indiana University Health Plans
  • Paula Herrmann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Systems Analyst at Physicians Health Plan
  • Melodie Humphries
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, UM Intake at Community Health Plan of Washington
  • Allison Hurlock
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Dir. of Med. Mgt at CHRISTUS Health Plan
  • Michael Keeler
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Operating Officer at Health First Health Plans
  • Carol Kelley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Medical Management Analytics at Health Alliance Medical Plans
  • Maggie Kelley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Assistant Vice President, Medical Management at Community Health Options
  • Stacy Kessel
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CFO at Community Health Plan of Washington
  • Donna Klair
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • EDW Analyst at Health First Health Plans
  • Sarah Knoebel
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Actuarial Analyst at Geisinger Health Plan
  • Dustin Knotts
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Manager - Claims at Indiana University Health Plans
  • Linda Krause
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Clinical Management at SummaCare
  • Linda Lang
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director at Samaritan Health Plans
  • Audrianna Leeper
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager UM at Cook Childrens Health Plan
  • David Livingston
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CEO at Prominence Health Plan
  • Cathy Lyons
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Integrated Care Manager at Health New England
  • Brian Merkey
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Actuarial Specialist at Quartz Health Solutions
  • Arik Olson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Director at Samaritan Health Plans
  • Gretchen Oswald
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Health Care Data and Analysis at Community Health Plan of Washington
  • Scott Pedersen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager Financial Planning & Analysis at Samaritan Health Plans
  • Dawn Peterson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Utilization Management and Risk Adjustment Solutions at Health Alliance Medical Plans
  • Jill Piazza
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President, Care Integration and Member Experience at Adventist Health System
  • Amy Reid
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Operations Director at Health First Health Plans
  • Dianne Rich
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Utilization Mangement at Neighborhood Health Plan of Rhode Island
  • Kristin Rodriguez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Knowledge Officer at Health Plan Alliance
  • Lisa Rogers
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Utilization/Case Management-Northern Region at Paramount Health Care
  • Deborah Rollston
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Population Health Management - Commercial/CHIP at Community First Health Plans
  • Krista Schonrock
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Director at SelectHealth
  • Jeremiah Simpson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Clinical Service STAR Kids Program at Community First Health Plans
  • Alan Sokolow
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Medical Officer at Aspire Health Plan
  • Jackie Stadler
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Improvement Specialist-HP at Gundersen Health System, Inc.
  • Randy Stein
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Manager at Neighborhood Health Plan of Rhode Island
  • Karla Tull
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager Underwriting at CommunityCare
  • Tyler Tyburski
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Care Manager at Community Health Options
  • Adolfo Valadez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CMO at FirstCare Health Plans
  • Roberta Van Scoyk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Technical Medical Management at Samaritan Health Plans
  • April Vogelsang
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Medical Management and Case Management at Health Alliance Medical Plans
  • Jenny Vu
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • UM Supervisor at Valley Health Plan
  • Meryl Weinberg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • DED Medical Management at MetroPlus Health Plan
  • Lynn Williams
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Medical Management at AvMed
  • Sarah Wilmot
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Healthcare Economics Analyst at Community Health Plan of Washington
  • Jered Wilson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Managed Care at Paramount Health Care
  • Itasha Yamamoto
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Case Management Supervisor at Valley Health Plan
  • Bonnie Zito
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • UM Regulatory Compliance Coordinator at Paramount Health Care