A fresh Administration = New Challenges for Options & Companies ⚡Although last regulatory steering has not been introduced yet, wellbeing options and companies must be all set to act quick when variations strike. An agile method and a chance to speedily deploy specialist groups might be critical. Medicare Advantage:
This breadth of hands-on operational and regulatory experience will allow us to speedily evaluate the complexities that your Firm faces also to bring concrete and in-depth
Dr. Chapman has served as Healthcare Director to get a well being plan with in excess of a million users in industrial, Medicare Edge and Medicaid goods. In his do the job with ATTAC purchasers, he focuses on the scientific areas of managed care, top quality and STAR programs, like advancement and software of utilization management criteria, high-quality monitoring and interventions, and producing operational efficiencies in medical system software to scale back administrative costs.
Notably, he reengineered scientific processes that resulted in a very minimize in Medicare appeals by 21% in only six months. This accomplishment improved customer fulfillment, Improved statements’ processing effectiveness, and reduced administrative fees.
Our clients rely on ACG to provide specialist regulatory assistance, to implement robust compliance answers also to perform productive, professional auditing. Our health care and pharmacy groups are guiding businesses in adoption of latest designs to deal with care in a value-powerful way.
In addition, she has efficiently led statewide expansions and community adequacy company contracting builds across several states.
Her Management has regularly improved operational effectiveness, Price tag Handle, and service provider satisfaction, although keeping the best benchmarks of regulatory and accreditation compliance.
He's a a flight surgeon while in the Michigan Air National Guard, in which he continues to be decorated for negotiating a bilateral Intercontinental agreement on health-related licensure.
We are a healthcare consulting agency specializing in operations and Health care compliance remedies for wellness insurers and managed care businesses
Laurie is part of ACG’s scientific pharmacy observe group serving all system segments. She has substantial encounter in scientific and operational management of pharmaceutical solutions in an entire scope of healthcare environments, together with Medicare wellbeing plans, acute care and LTC arenas. Her multi-field abilities has incorporated built-in medical and operational strategic planning, pharmacy community oversight, PBM oversight, pharmaceutical contract evaluation and negotiation, and procedure reengineering to boost margin and compliance.
Jon is actually a seasoned executive guiding hazard adjustment systems for Medicare Benefit, ACA /Marketplace and Medicaid courses. He delivers know-how in improvement and implementation of helpful possible and retrospective threat adjustment initiatives, correctly qualified To optimize ROI. He's deeply skilled at guiding and developing analytics to establish/suspect prospective risk adjustment prospects, in addition to checking for inappropriately coded claims and diagnoses to be certain accuracy in hazard adjustment submissions to the MA Come across Details Processing Techniques and ACA Edge Servers.
Erin is a highly trained and effective Medicare Advantage compliance Expert with 10 decades of working experience while in the healthcare marketplace. Erin’s track record features leadership positions healthcare compliance audit in Medicare gross sales compliance/agent oversight, compliance software effectiveness/administration, delegated entity oversight, and overall health approach operations.
Mia has greater than 16 several years of knowledge in regulatory compliance management which has a specialization in compliance in clinical activities and oversight of behavioral health and fitness and compound abuse companies. She delivers lawful, regulatory and compliance in medical solutions for industrial and Medicaid specialty in serious psychological health issues, in depth extensive-time period care and youngsters’s medical products and services.
Victoria held two executive roles having an Ohio wellness prepare serving more than one million customers. As Vice President of Clinical Operations, she led key initiatives in appeals management, scientific coaching, and regulatory compliance, noticeably bettering operational efficiencies and CMS audit readiness.