Healthcare Program Development

As the health care marketplace keeps changing with new regulations, updated standards, new ideas and processes, your company may need external support to revise or develop varied programs or needed updates for the healthcare program development services that you provide.

Our industry expert registered nurse consultants and other health experts, having more than 80 years of combined experience in managed healthcare, may be your answer, as you continue to grow or change!

We continuously stay updated regarding "best practices" in medical management, whether in response to utilization review, case management or performance improvement. We can help your company keep up to date with current standards and help you build programs to keep up with today's competition.

Utilization Review: As companies evaluate their Utilization Review requirements for prospective, admission, concurrent, or retrospective review, either telephonically or on-site, program changes may require a renewed focus and emphasis, governed by internal policies in response to external requirements. Our consultants have experience working with companies like yours, to help you stay current on state legislation or voluntary requirements that enable continued compliance.

Case Management: Our consultants work with case management companies and departments to enable a coordinated and integrated flow of operations, that can benefit staff, your customer, and the covered lives for whom you provide services.

Our experience includes working with varied organizations, i.e. insurance, MCO, TPA, case management departments, and hospitals, to enable policy, procedure and operations to "match up" to current standards of case management.

Strategic Planning: Our consultants can assist with strategic planning in the research, design, and development of managed care programs or initiatives consistent with the strategic goals of your organization. This includes consulting with management and internal staff, customers, providers, external vendors, and other health care-related organizations. Development and delivery of presentations, including a cost benefit analysis, can also be provided for project approval by senior leaders

Compliance or Performance Improvement: Day-to-day monitoring of quality and performance is an ongoing task for any organization. PSN works with companies that have asked us to provide focused staff support. A PSN consultant comes in once per calendar quarter, and performs monitoring activities, according to the organization's Quality Management plan. End result = monitoring is on schedule through the use of periodic external support. A benefit to you is continued compliance with your quality program needs and compliance requirements!