Leveraging Expertise and Innovation for Program Development Excellence
Our industry expert registered nurse consultants and healthcare experts, having more than 100 years of combined experience in managed healthcare, may be your answer, as you continue to grow or change!
We continuously stay updated regarding “best practices” in medical management, whether in response to utilization review, case management or performance improvement. We can help your company keep up to date with current standards and help you build programs to keep up with today’s competition.
Utilization Review: As companies evaluate their Utilization Review requirements for prospective, admission, concurrent, or retrospective review, either telephonically or on-site, program changes may require a renewed focus and emphasis, governed by internal policies in response to external requirements. Our consultants have experience working with companies like yours, to help you stay current on state legislation or voluntary requirements that enable continued compliance.
Case Management: Our consultants work with case management companies and departments to enable a coordinated and integrated flow of operations, that can benefit staff, your customer, and the covered lives for whom you provide services.
Our experience includes working with varied organizations, i.e. insurance, MCO, TPA, case management departments, and hospitals, to enable policy, procedure and operations to “match up” to current standards of case management.
Strategic Planning: Our consultants can assist with strategic planning in the research, design, and development of managed care programs or initiatives consistent with the strategic goals of your organization. This includes consulting with management and internal staff, customers, providers, external vendors, and other health care-related organizations. Development and delivery of presentations, including a cost benefit analysis, can also be provided for project approval by senior leaders.
Compliance or Performance Improvement: Day-to-day monitoring of quality and performance is an ongoing task for any organization. PSN works with companies that have asked us to provide focused staff support. A PSN consultant comes in once per calendar quarter, and performs monitoring activities, according to the organization’s Quality Management plan. End result = monitoring is on schedule through the use of periodic external support. A benefit to you is continued compliance with your quality program needs and compliance requirements!
HEDIS: PSN has expert HEDIS consultants who are able to help your organization maintain compliance during annual reviews. This can range from Provider/Staff Education, to assisting you with the creation of a new department.
What our Clients Say:
“I feel we have a true partnership in working with our PSN Consultant; she invests a great deal of heart and soul in her work.”
Healthcare IT Company, Colorado
“Our PSN consultant’s skill set exceeded the job requirements. She has provided us excellent direction as to how to streamline the presentation of our documentation to direct surveyors in their reviews, how to demonstrate standards are met, the use of specific language to show alignment with standards, and how to create reports that clearly summarize expected results and metrics. We have been thrilled with her support to our team.”
Healthcare IT Company, Colordo
“We are very happy with our PSN Consultants; they are providing invaluable expertise as we pursue the NCQA accreditation. I know we could not do without their expertise; and they are easy to work with, which is a big plus.”
Health Plan, Pennsylvania
“As an organization, we were confident to rely on the PSN consultant’s expertise to guide us through the health plan accreditation process. She is a top-notch consultant who I would recommend at the highest possible level.”
Health Plan, Delaware
“We are very pleased with our PSN Consultant. She was approachable, timely in her turnaround time, and the team enjoyed working with her. Her comments and mock interviews were spot on.”
Health Plan, Ohio
“I feel we have a true partnership in working with our PSN Consultant; she invests a great deal of heart and soul in her work.”
Healthcare IT Company, Colorado
“Our PSN consultant’s skill set exceeded the job requirements. She has provided us excellent direction as to how to streamline the presentation of our documentation to direct surveyors in their reviews, how to demonstrate standards are met, the use of specific language to show alignment with standards, and how to create reports that clearly summarize expected results and metrics. We have been thrilled with her support to our team.”
Healthcare IT Company, Colordo
“We are very happy with our PSN Consultants; they are providing invaluable expertise as we pursue the NCQA accreditation. I know we could not do without their expertise; and they are easy to work with, which is a big plus.”
Health Plan, Pennsylvania
“As an organization, we were confident to rely on the PSN consultant’s expertise to guide us through the health plan accreditation process. She is a top-notch consultant who I would recommend at the highest possible level.”
Health Plan, Delaware
“We are very pleased with our PSN Consultant. She was approachable, timely in her turnaround time, and the team enjoyed working with her. Her comments and mock interviews were spot on.”
Health Plan, Ohio
“I feel we have a true partnership in working with our PSN Consultant; she invests a great deal of heart and soul in her work.”
Healthcare IT Company, Colorado