Payer

For many payers, utilization management is still synonymous with prior authorization. But that narrow view can lead to missed opportunities, care delays and member dissatisfaction. This session explores how leading health plans are reframing UM as a proactive strategy to…

Venous leg ulcers (VLUs) remain one of the most persistent, costly chronic wounds in payer networks. Current treatments often fall short and coverage policies overlook promising alternatives. But new clinical evidence may change that. Join a discussion that explores findings…

Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom. This webinar breaks down new national research on UM practices across…

Manual processes, fragmented systems and unstructured data are slowing payers down and driving up costs. Priority Health faced the same challenges but instead of patching over inefficiencies, the organization reengineered its operations with automation, unlocking faster service and smarter decision-making.…

Navigating healthcare shouldn’t feel like a maze, but for many members, it still does When clinical guidance, provider search, program access, and benefits navigation are disconnected, members get frustrated and don’t use services, while health plans face rising costs. Trust…

CMS’ Interoperability and Prior Authorization Final Rule (CMS-0057-F) outlines the path toward industry-wide electronic prior authorization, but real-world implementation remains fragmented — even among early adopters. From investment hesitancy to misaligned workflows to gaps in CMS provisions, health systems and…

Price transparency mandates have introduced an unprecedented volume of data — but turning that data into actionable strategy remains a challenge. Health systems and payers alike are still navigating how to translate pricing insights into stronger contract terms, smarter network…

Presenters Alexandra Anderson, Head of Health Plan Strategy & Sales, Color Health Keegan Duchicela, MD, Director Medical Affairs, Color Health Dr. Rebecca Miksad, Chief Medical Officer, Color Health  

Presenters Karen Blizzard, CPCS, Credentialing Manager, Symplr Jennifer Cloud, CPMSM, CPCS, Vice President of Credentialing Operations, Symplr

 Panelists Katherine Schneider, MD, MPhil., FAAFP, Chief Medical Officer, Medecision Ria Paul, MD, Chief Medical Officer, Santa Clara Family Health Plan Lori Tishler, MD, MPH, Chief Medical Officer, Community Health Options Namita Yende, MD, Associate Chief Medical Officer & Senior…