New Video Bundle

Utilization Management Summit

Recorded October 2020

13 sessions from your peers in Utilization Management. Get instant access to the video recordings and presentation slides.

Utilization Management: Addressing Crucial Challenges for Health Plans

Videos Included in the Bundle


SPECIAL WORKSHOP: Ensuring Success with UM Requirements for Health Plan Accreditation

Moderator:
Erik Baldwin, MBA, Director, Pay for Value
GATEWAY HEALTH PLAN

Speakers:
Kirk McDonald, PhD, Program Manager, Clinical Operations
SAN FRANCISCO HEALTH PLAN

Joel Nellis, MPH, NCQA Project Manager, Compliance & Regulatory Affairs
SAN FRANCISCO HEALTH PLAN

Sarah Dencker MSN, RN, Director Utilization Management
NETWORK HEALTH

Examining the Challenges of Observation Status vs. Inpatient Admission—Health Plan and Hospital Perspectives

Timothy Law, DO, MBA, Senior Medical Director
HIGHMARK

Carissa Tyo, MD, Medical Director, Clinical Decision Unit
UNIVERSITY OF ILLINOIS HOSPITAL

Optimizing Utilization and Care Management by Taking into Account Your Members’ “Health Literacy”: Better Understanding How They Comprehend and Utilize Health Information

Sunil Kripalani, MD, Professor of Medicine; Director, Center for Clinical Quality and Implementation Research; Co-Director, Center for Effective Health Communication
VANDERBILT UNIVERSITY MEDICAL CENTER

Featured Session: Integrating Social Determinants of Health into UM and Care Management Processes to Optimize Outcomes and Improve Value

Jim Milanowski, President and CEO
GENESEE HEALTH PLAN

Mouhanad Hammami, MD, MHSA, Chief Health Strategist
WAYNE COUNTY, MICHIGAN
Former Senior Vice President, Safety Net Transformation, Community Health & Wellbeing
TRINITY HEALTH

Improving Outcomes and Containing Costs by Detecting Unrecognized or Unmet Behavioral Health Needs

Andrew Philip, PhD, LP, Senior Director, Clinical & Population Health
PRIMARY CARE DEVELOPMENT CORPORATION

Mary M. Ford, Director, Evaluation and Analytics
PRIMARY CARE DEVELOPMENT CORPORATION

Managing Telehealth Benefits to Ensure Effective Care

Monica Chmielewski, JD, Partner
FOLEY & LARDNER

Til Jolly, MD, Emergency Physician
INOVA HEALTH SYSTEM

Featured Panel Discussion: Ensuring UM, Care Management and Quality Improvement Departments All Work Together More Effectively

Moderator:
Jim Milanowski, President and CEO
GENESEE HEALTH PLAN

Panelists:
Jatin Dave, MD, MPH, Chief Medical Officer
MASSHEALTH

Timothy Law, DO, MBA, Senior Medical Director
HIGHMARK

Monica Baldzikowski, RN, PHN, Senior Manager, Prior Authorizations and Quality Review
SAN FRANCISCO HEALTH PLAN

Special Feature: Effectively Managing Gender Affirmation Services, Policies, and Criteria

Monica Baldzikowski, RN, PHN, Senior Manager, Prior Authorizations and Quality Review
SAN FRANCISCO HEALTH PLAN

Kirk McDonald, PhD, Program Manager, Clinical Operations
SAN FRANCISCO HEALTH PLAN

Case Study: Optimizing Outcomes through Improved Payer/Provider Collaboration

MJ Tran, MBA, ACO Director
HCA HEALTHCARE & EASTERN IDAHO CARE PARTNERS ACO

Feedback from Other Organizations


"Presentations are relevant to challenges across most health plans and provide valuable insight into approaches and solutions of other payers."

Stefanie Z. with Humana Military

“Great cross section of payers and providers giving points of view we would not normally think of.”

Mark G. with Ochsner Health Network

“Many different unique and cost-effective management ideas.”

Heidi L. with Medical Associates Health Plans

“Wonderful opportunity to network with other UM professionals. Balanced breath of talks from various sides of the business.”

Kelly A. with Informed DNA

“The networking and group interaction were wonderful.”

Lori D. with Southeastern Regional Medical Center

It was an open forum to discuss our concerns, challenges, barriers, hopes and goals. Greatly appreciated.”

Roxan S. with AIDS Healthcare Foundation- Positive Healthcare Partners

Sponsors


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