Utilization Manager
Not what you're looking for?
For this assignment you are to interview a utilization manager, disease manager, or case manager at a local hospital or home health agency. Use your textbook (essentials managed health care) as a guide to develop a set of questions regarding the role of the person you are interviewing and investigate how he/she perceives the impact of his/her role on cost management and quality of patient care. Also, determine the relationship between this role and that of the health care administrator.
Purchase this Solution
Solution Summary
This solution explains the role of the utilization manager in managed healthcare services. The sources used are also included in the solution.
Solution Preview
Step 1
Interview with utilization manager
Q. What is your role at our local hospital?
UM. I am responsible for high quality, medical outcomes for patients who are enrolled with us. I must also ensure that the treatment is cost efficient.
Q. What are your responsibilities?
UM: I must screen those persons who are enrolled for case management and disease management.
Step 2
Q. What is the impact of your role on cost management?
UM: The effect of my position on cost management is substantial. I review precertification requests for medical necessity. Those who require additional specialization are referred to the Healthcare Administrator. I also review clinical information for concurrent reviews and ...
Purchase this Solution
Free BrainMass Quizzes
Accounting: Statement of Cash flows
This quiz tests your knowledge of the components of the statements of cash flows and the methods used to determine cash flows.
Motivation
This tests some key elements of major motivation theories.
Business Processes
This quiz is intended to help business students better understand business processes, including those related to manufacturing and marketing. The questions focus on terms used to describe business processes and marketing activities.
Basic Social Media Concepts
The quiz will test your knowledge on basic social media concepts.
SWOT
This quiz will test your understanding of the SWOT analysis, including terms, concepts, uses, advantages, and process.