Care Management Services

Care Management International (CMI) delivers utilization management, case management, disease management, pharmacy management, and data analysis services to healthcare companies using an integrated onshore/offshore model. We associate with best-in-class, well-established partners, beginning with a global company based in India that specializes in business process outsourcing (BPO) for multiple industry categories. Our model provides staffing and support for non-regulated components of the clinical processes, leaving core and regulated functions in our clients' control.

CMI enhances the value of our clients' medical management programs with a full range of clinical business process outsourcing (BPO) services that optimize performance and lower costs, including:

Transaction-Based Care Management Support

Outbound Calling

»	Health Risk Assessment
»	Discharge Follow-up
»	Coordination of Preventive Services and Reminder Programs (HEDIS)
»	Pharmaceutical Brand/Generic Switching
»	Care Management and Disease Management Screening and Enrollment
»	Pharmacy Compliance

Inbound Calling

»	24/7 Call Triage and Management
»	General and Select High-Cost Prior Authorization(s), including Rx
»	Concurrent Review Support

Staff Augmentation

»	Clinical Staff Support (Turnover/Vacancy Management)

Consultative and Analytic Support

Data Management and Analytics

»	Predictive Modeling
»	Claims Mining for Disease Management Program Candidates

Guideline and Policy Creation and Maintenance

»	Supporting Research
»	Guideline Creation
»	Documentation and Maintenance

Care Planning Support

»	Collection of Clinical Data For Select Members
»	Physician Assessment and Assembly of a Clinical Care Plan Recommendation
»	Documentation Support

CMI's services are provided via inbound and outbound 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. Our offshore operating centers are staffed by qualified clinical and analytical professionals. CMI complies with all state and Federal regulatory and accreditation requirements and standards.