In addition to tremendous cost pressures from healthcare payers, insurance companies are struggling to realize ROI from their clinical programs and challenged to justify investment in proactive measures for health and wellness. Our client, a large group health plan, faced these issues: corporate mandate to cut medical management costs, inconsistent nurse productivity rates, staffing for case management operations and rising clinical labor costs adding to already escalating operational costs.
Our Global Clinical Services team deployed more than 150 registered nurses as a turnkey solution for the Utilization Management continuum, including Intake, Nurse Review and Peer Review Preparation. These were experienced US-accredited RNs operating from URAC certified facilities in the Philippines, with deep domain expertise in case management. As a result, we were able to reduce operating costs by more than 40%, while increasing turn around time compliance to more than 99%.