Utilization Management Toolkit

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Save time, empower your teams and effectively upgrade your processes with access to this practical Utilization management Toolkit and guide. Address common challenges with best-practice templates, step-by-step work plans and maturity diagnostics for any Utilization management related project.

Download the Toolkit and in Three Steps you will be guided from idea to implementation results.

The Toolkit contains the following practical and powerful enablers with new and updated Utilization management specific requirements:


STEP 1: Get your bearings

Start with...

  • The latest quick edition of the Utilization management Self Assessment book in PDF containing 49 requirements to perform a quickscan, get an overview and share with stakeholders.

Organized in a data driven improvement cycle RDMAICS (Recognize, Define, Measure, Analyze, Improve, Control and Sustain), check the…

  • Example pre-filled Self-Assessment Excel Dashboard to get familiar with results generation

Then find your goals...


STEP 2: Set concrete goals, tasks, dates and numbers you can track

Featuring 999 new and updated case-based questions, organized into seven core areas of process design, this Self-Assessment will help you identify areas in which Utilization management improvements can be made.

Examples; 10 of the 999 standard requirements:

  1. What steps will be taken by the review organization to ensure that duplicate bills will be screened and identified to preclude being audited twice?

  2. Are clinical criteria imbedded within the care management system to facilitate consistent interpretation and use of criteria by staff members?

  3. Are there any other potential interventions that might have more value for a health plan that the health plan could consider applying?

  4. What lead time does your organization require to successfully implement a comprehensive, coordinated disease management program?

  5. What is the level of current utilization of each service, and what incremental enhancements to existing services are possible?

  6. What are the evidence-based guidelines regarding repeat routine organization tests for clients in acute care settings?

  7. Should the health plan perform more or less of a specific intervention or perhaps change the intervention target?

  8. Is utilization review or some other sort of medical review required to make a prior authorization determination?

  9. Do you know of a healthcare facility that has dealt with a technology-related issue and has a story to share?

  10. Will you permit the client or its designated consultant to access your system and its analytic capabilities?


Complete the self assessment, on your own or with a team in a workshop setting. Use the workbook together with the self assessment requirements spreadsheet:

  • The workbook is the latest in-depth complete edition of the Utilization management book in PDF containing 999 requirements, which criteria correspond to the criteria in...

Your Utilization management self-assessment dashboard which gives you your dynamically prioritized projects-ready tool and shows your organization exactly what to do next:

  • The Self-Assessment Excel Dashboard; with the Utilization management Self-Assessment and Scorecard you will develop a clear picture of which Utilization management areas need attention, which requirements you should focus on and who will be responsible for them:

    • Shows your organization instant insight in areas for improvement: Auto generates reports, radar chart for maturity assessment, insights per process and participant and bespoke, ready to use, RACI Matrix
    • Gives you a professional Dashboard to guide and perform a thorough Utilization management Self-Assessment
    • Is secure: Ensures offline data protection of your Self-Assessment results
    • Dynamically prioritized projects-ready RACI Matrix shows your organization exactly what to do next:

 

STEP 3: Implement, Track, follow up and revise strategy

The outcomes of STEP 2, the self assessment, are the inputs for STEP 3; Start and manage Utilization management projects with the 62 implementation resources:

  • 62 step-by-step Utilization management Project Management Form Templates covering over 1500 Utilization management project requirements and success criteria:

Examples; 10 of the check box criteria:

  1. Activity Duration Estimates: Is a contract developed which obligates the seller and the buyer?

  2. Quality Audit: Do the acceptance procedures and specifications include the criteria for acceptance/rejection, define the process to be used, and specify the measuring and test equipment that is to be used?

  3. Variance Analysis: Is the anticipated (firm and potential) business base Utilization management projected in a rational, consistent manner?

  4. Lessons Learned: To what extent was the evolution of risks communicated?

  5. Team Member Performance Assessment: What are best practices for delivering and developing training evaluations to maximize the benefits of leveraging emerging technologies?

  6. Activity Duration Estimates: Is action taken to increase the effectiveness and efficiency of Utilization management projects?

  7. Requirements Management Plan: Will the Utilization management project requirements become approved in writing?

  8. Project Portfolio management: Why would the work force want to know the force rank order of the portfolio?

  9. Change Management Plan: Have the business unit contacts been selected and notified?

  10. WBS Dictionary: Is the anticipated (firm and potential) business base Utilization management projected in a rational, consistent manner?

 
Step-by-step and complete Utilization management Project Management Forms and Templates including check box criteria and templates.

1.0 Initiating Process Group:

  • 1.1 Utilization management project Charter
  • 1.2 Stakeholder Register
  • 1.3 Stakeholder Analysis Matrix


2.0 Planning Process Group:

  • 2.1 Utilization management project Management Plan
  • 2.2 Scope Management Plan
  • 2.3 Requirements Management Plan
  • 2.4 Requirements Documentation
  • 2.5 Requirements Traceability Matrix
  • 2.6 Utilization management project Scope Statement
  • 2.7 Assumption and Constraint Log
  • 2.8 Work Breakdown Structure
  • 2.9 WBS Dictionary
  • 2.10 Schedule Management Plan
  • 2.11 Activity List
  • 2.12 Activity Attributes
  • 2.13 Milestone List
  • 2.14 Network Diagram
  • 2.15 Activity Resource Requirements
  • 2.16 Resource Breakdown Structure
  • 2.17 Activity Duration Estimates
  • 2.18 Duration Estimating Worksheet
  • 2.19 Utilization management project Schedule
  • 2.20 Cost Management Plan
  • 2.21 Activity Cost Estimates
  • 2.22 Cost Estimating Worksheet
  • 2.23 Cost Baseline
  • 2.24 Quality Management Plan
  • 2.25 Quality Metrics
  • 2.26 Process Improvement Plan
  • 2.27 Responsibility Assignment Matrix
  • 2.28 Roles and Responsibilities
  • 2.29 Human Resource Management Plan
  • 2.30 Communications Management Plan
  • 2.31 Risk Management Plan
  • 2.32 Risk Register
  • 2.33 Probability and Impact Assessment
  • 2.34 Probability and Impact Matrix
  • 2.35 Risk Data Sheet
  • 2.36 Procurement Management Plan
  • 2.37 Source Selection Criteria
  • 2.38 Stakeholder Management Plan
  • 2.39 Change Management Plan


3.0 Executing Process Group:

  • 3.1 Team Member Status Report
  • 3.2 Change Request
  • 3.3 Change Log
  • 3.4 Decision Log
  • 3.5 Quality Audit
  • 3.6 Team Directory
  • 3.7 Team Operating Agreement
  • 3.8 Team Performance Assessment
  • 3.9 Team Member Performance Assessment
  • 3.10 Issue Log


4.0 Monitoring and Controlling Process Group:

  • 4.1 Utilization management project Performance Report
  • 4.2 Variance Analysis
  • 4.3 Earned Value Status
  • 4.4 Risk Audit
  • 4.5 Contractor Status Report
  • 4.6 Formal Acceptance


5.0 Closing Process Group:

  • 5.1 Procurement Audit
  • 5.2 Contract Close-Out
  • 5.3 Utilization management project or Phase Close-Out
  • 5.4 Lessons Learned

 

Results

With this Three Step process you will have all the tools you need for any Utilization management project with this in-depth Utilization management Toolkit.

In using the Toolkit you will be better able to:

  • Diagnose Utilization management projects, initiatives, organizations, businesses and processes using accepted diagnostic standards and practices
  • Implement evidence-based best practice strategies aligned with overall goals
  • Integrate recent advances in Utilization management and put process design strategies into practice according to best practice guidelines

Defining, designing, creating, and implementing a process to solve a business challenge or meet a business objective is the most valuable role; In EVERY company, organization and department.

Unless you are talking a one-time, single-use project within a business, there should be a process. Whether that process is managed and implemented by humans, AI, or a combination of the two, it needs to be designed by someone with a complex enough perspective to ask the right questions. Someone capable of asking the right questions and step back and say, 'What are we really trying to accomplish here? And is there a different way to look at it?'

This Toolkit empowers people to do just that - whether their title is entrepreneur, manager, consultant, (Vice-)President, CxO etc... - they are the people who rule the future. They are the person who asks the right questions to make Utilization management investments work better.

This Utilization management All-Inclusive Toolkit enables You to be that person.

 

Includes lifetime updates

Every self assessment comes with Lifetime Updates and Lifetime Free Updated Books. Lifetime Updates is an industry-first feature which allows you to receive verified self assessment updates, ensuring you always have the most accurate information at your fingertips.