Frequently Asked Questions
What is Care Management International?
Care Management International (CMI) is a U.S. corporation headquartered in New Jersey, that supports the delivery of clinical services for healthcare clients such as utilization management, radiology management, case management, disease management, HEDIS improvement, pharmacy management, and data analysis and provides sophisticated call center and business process outsourcing services to clients in select non-healthcare industries. We offer our healthcare clients the opportunity to reduce spending and improve performance in critical areas through a unique collaboration that links each client's medical management processes and clinical support technology with CMI's integrated, U.S. and overseas operations and business process outsourcing (BPO) capabilities. We offer our non-healthcare clients the opportunity of significantly expanding their operational performance while reducing their operational expenses. With CMI, healthcare clients can redeploy scarce clinical resources to under-funded and new, high-priority programs that focus on improving the experience and quality of healthcare delivery and non-healthcare clients can become more competitive.
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What kind of programs does Care Management International offer?
Care Management International (CMI) provides expertise in the following industries: healthcare, financial services, and publications. CMI offers a wide variety or smart sourcing solutions to healthcare clients. Basically any service provided by a healthcare company that is typically run by a clinical manager or has an element of clinical oversight or insight required to successfully operate is an activity that CMI can typically support. Our focus in these areas is to increase our clients’ effectiveness, efficiency, and productivity with the intent of improving outcomes and providing enhanced clinical opportunities to improve members’ clinical experience. In financial services and publications, CMI provides expert operational capabilities and sophisticated call center infrastructure so that our clients can dramatically increase their productivity and accomplish more with less resources.
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What clinical improvements does Care Management International support?
Care Management International provides a wide range of clinical support services that allow clients to:
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Improve care management models through access to qualified, rare technical and professional skill-sets at affordable cost levels. |
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Increase care planning and health-management program utilization through additional data collection, analysis, and member identification. |
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Establish value-added programs specifically designed to improve clinical quality and outcomes. |
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Achieve a return on investment (ROI) on clinical programs that have traditionally been too cost-prohibitive to implement. |
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Reduce cycle times and improve staffing flexibility, facilitated by 24/7 resources. |
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Produce immediate administrative savings that can bridge the gap between current operations and the implementation of future automation. |
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Is offshore support of clinical programs a brand new concept?
While it is true that Care Management International is a pioneer in developing an integrated onshore/offshore model for clinical outsourcing, the underlying technology is well established and many organizations in the healthcare sector have been using outsourcing, including offshore resources, to improve efficiency, turnaround times and service quality for a number of years. CMI's unique approach links each client's medical management processes and clinical support technology with our world-class service design, integrated U.S. and overseas operations, and business process outsourcing capabilities. Using highly trained clinical staff and evidence-based processes, we offer our clients the opportunity to manage spending on utilization management, radiology management, case management, disease management, pharmacy management, HEDIS improvement and data analysis, and to redeploy scare clinical resources to under-funded and new high-priority programs that focus on improving the experience and quality of healthcare delivery.
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Will Care Management International's services be customized for my clinical programs?
Yes. Care Management International employs a number of approaches and stages for client engagement in order to ensure the best possible fit between the client's needs and CMI's capabilities. They include:
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An Executive Briefing about the general opportunities provided by CMI's care management model. |
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An initial Enterprise Assessment, which identifies the most appropriate immediate areas of opportunity for new or enhanced care management programs. |
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A proposal and initial ROI analysis for the care management programs the potential client would like to establish or enhance. |
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A site visit to CMI's operations by the client. |
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A 10-Week Executive Investigative Process, including a formal agreement to assign staff and allocate attention to the evaluation of the value proposition, the design of customized solutions, and the structure of a legal agreement between the organizations. |
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CMI custom-designs each program as needed to guarantee that all regulated and high-priority customer processes remain under specific management of the client. This allows for a greater focus by the client on those areas most important for driving quality and successful cost management. |
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Is Care Management International a disease management company or a medical management company?
Care Management International is not a disease management company and does not deliver clinical services that would typically fall within the regulated activities associated directly with the practice of medicine. Care Management International provides support to healthcare companies that ultimately deliver clinical services in order to make them more efficient, productive, and competitive. One of the fundamental beliefs of Care Management International is that care management activities, defined very broadly, are and should be a core competency and market differentiator of our clients and as such our mission is to make our clients more effective by increasing their capabilities instead of what most outsourcing companies do: replace or remove those capabilities from a client portfolio.
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What is business process outsourcing (BPO)?
Business process outsourcing (BPO) is the practice of contracting with third-party service providers of specific business tasks and transactions, including customer service, claims processing, IT, billing, accounting, payroll, benefits administration, research and analytics who focus primarily, if not exclusively, on those tasks in order to increase efficiencies. BPO is used in many industries, including healthcare, insurance, financial services, travel, professional services, manufacturing, distribution and retail. BPO that is contracted outside a company's own country is usually called offshore outsourcing, and BPO that is contracted within the company's own county is usually called onshore outsourcing.
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Are offshore staff trained to overcome potential language and cultural differences?
Most definitely. Care Management International provides focused training and ongoing educational programs to help our associates achieve clinical, linguistic and cultural core-content expertise. Our recruitment, screening and hiring procedures are designed to enable us to recruit and retain the best possible talent with the right skills. Specific staffing profiles for each client's business processes are agreed upon at the commencement of the engagement. We strongly encourage our clients to visit our offshore operations in India as part of their assessment process and to experience, in real time, the high levels of service and quality provided by CMI.
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If Care Management International's offshore outsourcing services are based in India, will they always be available when I need them?
Yes. Care Management International's services are provided via in-bound and out-bound telephone, email and live-chat support, and they are available around-the-clock, both on a real-time basis during our clients' business hours, and on a consultative or flex-time basis at any time. We operate a 24/7 facility that allows our clients maximum flexibility in meeting their productivity needs.
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Does Care Management International have any onshore US staff?
Yes, in fact Care Management International's onshore presence is substantial. We are a US-based corporation with our corporate headquarters in NJ and a full operations center in central Massachusetts. . Many other international companies and especially organizations engaged in BPO (business process outsourcing) services base their staff offshore and keep a small sales presence onshore. This reduces their expenses and Care Management International also believes limits their ability to provide the highest level of service and progressively valuable insight to clients over time. Care Management International operates two offices in the US and we staff these offices with all functional disciplines required to interact and relate to clients, including: account management, information technology, finance and reporting, clinical quality and oversight, project management, product development, quality management, sales and marketing, and operations staff for client programs.
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What kind of staff does Care Management International have in its offshore facilities?
For those of you who have never had the opportunity to travel to India, it is quite a diverse country; very different from the US on a number of dimensions. Similar to the US, however, India has a deep and rich educational system, a longstanding and effective service industry and culture, and a positive political and economic climate. Care Management International chose India as the locus for its first two operating facilities after a careful global consideration and then within India chose its region and city after an extensive and careful evaluation of a large number of criteria involving the availability and qualifications of staff. CMI has access to the following types of staff at its current facilities: clinical research specialists, quality assurance professionals, analysts and programmers, medical writers, customer service associates, BPO managers, physicians, nurses, pharmacists, dentists, and a variety of accent neutral call center staffing.
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Are there legal or regulatory issues with offshore outsourcing of clinical services?
The operations of Care Management International's business are structured to be consistent and compliant with ALL legal and regulatory requirements. Actions and activities that are legally mandated as the specific responsibility of a financial services customer, health plan, or clinical customer will not be conducted by CMI but will at all times remain the operational responsibility of the client. CMI utilizes its expertise to specifically design its programs to achieve maximum productivity and maximum client support while staying well within the bounds of all requirements whether legal, regulatory, or client specific.
How are security and HIPAA compliance ensured?
As a Business Associate to its clients, Care Management International ensures strict privacy, security, and full HIPAA compliance in a variety of ways, including employee practices, data privacy, physical security, transaction standards, disaster management, and additional measures that can be deployed on a process-specific basis as needed. All of CMI’s employees are HIPAA trained and certified, regardless of whether they work with healthcare clients and our facility is specifically designed to superior standards to ensure physical security of all client data.
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An integrated onshore/offshore approach helps clients to focus on areas of greatest importance
Our Q&A gives you a quick overview of Care Management International
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