Care Management International

How An Integrated Onshore/Offshore Clinical Model Can Work

In the delivery of care management programs it is essential that some services are delivered with a local and a regional presence. This might be because of a specific regulatory requirement, the particular business need of an end-client, or because clinical common sense determines that the most effective solution is delivered locally. Care Management International (CARE) knows which services must or should be delivered from an onshore locale and which services can be advantaged from the application of smart sourcing solutions. CARE applies this insight with an ability to customize its programs to deliver smart sourcing solutions to healthcare companies with a focus on enhancing the clients’ core competencies and effectiveness in care management and their ability to achieve positive clinical outcomes.

Our services are designed by healthcare experts and apply new techniques, global resources, and advanced technology solutions to drive positive clinical outcomes and create true market differentiation for our clients in case management, disease management, utilization management, radiology management, pharmacy management, and data analytics. By using expert clinical and non-clinical talent, working in HIPAA-compliant, state-of-the-art facilities, our smart sourcing model gives healthcare companies the ability to enhance the value of their medical management programs.

Smart sourcing works by determining which elements of a medical management process can be conducted offshore, onshore, or with technology and creates customized programs that achieve superior results by applying “the right talent, to the right task, at the right time, using the right cost structure.” This expert-based methodology not only lowers costs but also facilitates innovation.

The model:

»	Systematically supports client retention, control, and optimization of all critical clinical decisions,
»	Provides insight and expert clinical program design in areas traditionally burdened by complex regulations, complicated technology, and misaligned incentives,
»	Determines which elements of a medical management process can be conducted offshore, onshore, or with technology,
»	Focuses on clinical and administrative processes within healthcare companies that would benefit from process redesign or the addition or replacement of clinical and trained non-clinical talent.
»	Addresses the gap that exists between a client’s ability to assign resources (including recruiting, staffing, training, scheduling, and technology) and the level truly required to obtain their desired program results,
»	Achieves cycle-time advantages and time-of-day flexibility through a 24/7 schedule,
»	Promotes the deliver of time-sensitive indications of clinical need with usable data so patient interventions and interactions can be maximized,
»	Frees-up client clinical staff from administrative duties allowing for greater time, attention and focus on clinical activities,
»	Can be established with simple technical interfaces allowing for minimal client input and minimum implementation cost,
»	Is flexible enough to utilize either customized data and reporting applications or existing client systems and workflows,
»	Can be highly customized by clinical and process experts to meet the specific care management needs of clients, and
»	Can be started as pilots and small proof of concept programs so value can be proven before large scale commitments need to be made.

CARE’s services can be provided from a variety of locations via in-bound and out-bound telephone, email, live-chat support, and traditional internal office methods, and 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 offices are staffed by qualified clinical, analytical, and customer service trained professionals. CARE complies with all regulatory and accreditation requirements and standards and our model provides staffing and support for processes enhancing our client’s core and regulated functions.

We focus on helping you apply “the right talent, to the right task, at the right time, using the right cost structure.” in order to IMPROVE YOUR BUSINESS.

Process Flow for Utilization Management Process:

Process Flow for Concurrent Review: Workflow