Large health insurance company, primarily
focused on group but had individual portfolio
to meet regulatory requirements. Plan
used a small staff of medical underwriters,
but had historically high turnover. When
the manager left, the department lost
its leadership and had no one to train
new staff. The Carrier contacted Medwise
Consulting Partners seeking a vendor who
could seamlessly take over the operations.
Medwise Consulting Partners staff worked
collaboratively with the carrier to assume
all underwriting functions within a two
week period. The Plan's customer satisfaction
increased along with the speed and accuracy
of the underwriting decisions.
Board of a regional health plan asked
Medwise staff to evaluate the plan's large
and small group premium rates. Medwise
was able to do a focused analysis of the
group's business to determine that the
plan's premium rates (and internal controls)
were not adequate and likely to result
in large underwriting losses.
New CEO of a Regional health plan asked
Medwise to assess the current underwriting
processes and staff. Medwise review uncovered
a variety of practices that were inconsistent
with the company's stated policies, did
not adequately account for changes to
risk or medical cost and had the potential
to become compliance issues as well. Medwise
staff prepared a focused report, including
a detailed action plan to correct the
A large regional health plan was faced
with the combination of key staff vacancies
along with an increase in new applications.
Medwise assigned a team of experienced
underwriters who served as extensions
of the company's own underwriting staff
- complete with remote system access to
their systems - from our Arizona office.
This allowed the plan the opportunity
to recruit and train additional staff
while maintaining the integrity and service
Provider sponsored health plan was faced
with the sudden departure of their CFO.
On short notice, Medwise deployed an experienced
health plan CFO to fill in while the plan
conducted a thorough search for the replacement.
The interim CFO was able to "hit the ground
running" immediately helping with several
key projects including an impending Medicare
bid, reconciliation of premium billing
and several large group renewals.
Medwise has numerous success stories where
they have provided immediate (and in some
cases, long term) interim management for
a plan's underwriting department. Every
situation is different, but the common
thread is the departure of the department
head in a job market where the position
is difficult to fill. Medwise team includes
experienced underwriting managers who
can walk in to a plan and immediately
be functional with no learning curve.
Medwise staff have helped rebuild departments,
improve processes, train newer staff and
support the sales team.
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