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Collaborating for Performance

Collaborating for Performance. Initial MTF Commanders Briefing. Introduction: UnitedHealthcare Military & Veterans. Our Values Integrity. Compassion. Relationships. Innovation. Performance. Meeting the Goals of the Quadruple Aim: Solutions to Meet MTF Needs.

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Collaborating for Performance

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  1. Collaborating for Performance • Initial MTF Commanders Briefing

  2. Introduction: UnitedHealthcare Military & Veterans Our Values Integrity. Compassion. Relationships. Innovation. Performance. Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  3. Meeting the Goals of the Quadruple Aim: Solutions to Meet MTF Needs Experienced team for high performance during transition and operations Comprehensive information and technologies to manage health services Expanded capabilities and resources to support beneficiaries and the Military Health System • Advanced integrated medical and behavioral health management programs • Comprehensive nationwide reach and interaction with quality health care providers • Leverage the best practices, solutions and innovations of one of the largest Healthcare Organization in the country • TRICARE-specific knowledge and expertise • Access and use of proven TRICARE operational tools, technologies, processes • Data and information for cost, quality and service management • Network and medical management technologies to manage and monitor care 5 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  4. Field Operations: Located to Support Commanders Tacoma, WA NW Region Office Minneapolis, MN Central Region Office San Diego, CA SW Region Office Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  5. Field Operations Organizational Structure UnitedHealthcare Military & Veterans uses its proven business segment organization Senior Executives Close to the Customer President & Program ExecutiveWest Region Regional Director CEO Northwest CEO Southwest & TROW Liaison CEO Central VP, Alaska VP, Hawaii LocalMTF Commander Area Directors Area Directors Area Directors Area Directors TSCs TSCs TSCs TSCs TSCs UMV’s empowered field operations team brings the local commanders and Regional Director a solutions-oriented point of contact in daily operations Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  6. Medical Management Services • Our Population Management Approach Supports The Military Health System Quadruple Aim • Readiness • Population Health • Positive Beneficiary Experience • Responsible Management of Health Care Costs • Integrated military and civilian chain of care throughout the entire wellness-to-illness continuum, across medical and behavioral domains • Focus on highest value opportunities to improve care; data-driven, evidence-based, proven best practices • Specialized programs and services customized to meet the unique needs of a mobile and diversified MHS and its beneficiaries Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  7. Resources and Capabilities: Network Development & Management Network – Complementary, not competing • We will minimize network disruption by focusing on current network footprint and existing PCMs during contracting • Network build is dynamic and tailored to your local needs • Sizing Model integrates network assets with MTF role/capabilities to meet access needs • We have broad and enduring relationships with providers based on effective communication MTF CivilianNetwork • Inputs • Encounters (visits)History • MTF Capabilities/Capacity • Exceptions • Beneficiary Population Output PurchasedCare NeedsReport, bySpecialty Network Sizing Model Demand for Services- MTF Capability/Capacity Target Network Needs+Contingency Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  8. Customer Service: TRICARE Integrated Service Organization UnitedHealthcare Military & Veterans will have a vertically integrated customer service approach; the TRICARE Integrated Service Organization (TISO) across all customer touch-points. Efforts will be undertaken throughout the course of the contract to improve effectiveness of the TRICARE Service Centers through integration into service solution. Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  9. Beneficiary Satisfaction & Customer Service Highly Satisfied Beneficiaries at Every Point of Contact through First Call Resolution • Maintain a customer-focused vision that is complementary to our commitment to the mission of the MHS and our mission to provide services to “help people live healthier lives” • One toll-free number for both beneficiaries and providers • Fully redundant, dual-location call center with advanced CRM capabilities • Advanced ARU (Automated Response Unit) for beneficiary and provider self-service • Rapid resolution escalation model helps ensure calls are resolved and closed without a subsequent callback from a customer. • Seamless coordination between Utilization Mgmt and Case Mgmt programs for continuity of services • Coordination with TRICARE Specialized Case Mgmt programs and with PCMs • Vertically integrate communication channels to provide access points for availability and multiple avenues for information and issue resolution. • Training and knowledge-based tools to enhance our staff’s ability to consistently provide high-quality customer-centric service and recognize the value of providing excellent service • Training programs focusing on the culture & uniqueness of the military family, including the challenges, goals and functioning of the MHS • After-hours provider locator service • Six Sigma expertise and qualifications and other process improvement techniques and tools to monitor and assess quality, resulting in consistent, constantly improved and innovative customer service solutions Help Solve Connect Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  10. UMV Customer Service Solution • Customer Service Features • Extended Customer Service Hours – • Call centers staffed M - F, 0700 – 1900 in each West Region time zone • After-hours Provider Search support (24x7) • • Customized web portals • TRICARE360.com provides links to key subportals for a “one-stop” resource for information and interaction with UnitedHealthcare Military & Veterans claims and customer service • • Web Mail (response within 4 business hours) • • Comprehensive integration of call services • Advanced applications used to enhance TRICARE customer service efficiency, effectiveness, and satisfaction • Claims-related calls serviced by PGBA • UMV Hub Sites • Phoenix, AZ (Primary Contact Center) • Salt Lake City, UT • Honolulu, HI • Florence, SC (PGBA) Florence, SC TSC Location Hub Location UnitedHealthcare Military & Veterans Customer Service Centers Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

  11. Thank you. Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

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