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End to End Enrollment: A Strategic Business and Architecture Guide By Salus One Ed
eBook (PDF): $109.00
This 238-page knowledge guide provides detailed information about membership processes required for various health insurance product types in its current state, related gaps across the industry, and... More > how to obtain the optimal target state solution in commercial and government payor organizations. It also provides the participant reader the information required to understand the underlying theory, working processes, necessary infrastructure to enable modernized end-to-end enrollment capabilities including: - core and voluntary enrollment, - support for all members and customers from application to disenrollment, - benefit enrollment communications,multiple enrollment methods (i.e. employer, independent), - typical individual and group enrollment,prototypical commercial payor system and process flows, - industry data collection and enrollment reporting methods, and - much more...< Less
Value Based Care: Mastering Provider Quality Ratings and Performance for Maximum Reimbursement By Salus One Ed
eBook (PDF): $149.00
This 460-page guide provides the reader comprehensive information required to understand the underlying theory, working processes, and necessary infrastructure to enable modernized provider quality... More > rating and reimbursement capabilities including: - understanding of payors difficulties in maintaining state and federal regulatory compliance in reporting clinical outcomes of current members - key industry drivers around ratings and reimbursements and how they individually and collectively affect payors, members, and providers - comparison of existing business and technical infrastructure versus optimal target state solutions required to efficiently manage ratings and outcomes - contribute to internal and external projects, current employers or other stakeholders within insurance environments - transition from fee-for-service to value-based reimbursement activities, - prototypical commercial payor system and process flows, industry data collection and enrollment reporting methods, - and much more...< Less
Essentials of Commercial Health Insurance: Operational Business Management, Architecture, and Infrastructure By Salus One Ed
eBook (PDF): $195.00
This two part course is a comprehensive knowledge guide about commercial healthcare payor organizations, their enterprise functions, and day-to-day business activities. It also provides the... More > participant reader the information required to understand the underlying theories, working processes, necessary infrastructure to understand health payor business capabilities including: - key functional components of health insurance businesses and interrelationships, - ongoing regulatory and competitive changes and their respective impact on organizational processes, systems architecture, and information assets, - support for all members and customers from application to disenrollment, - efficiently communicating with and managing provider needs and communications - multiple, modernized technologies and partner maintenance activities - typical individual and group enrollment, - prototypical commercial payor system and process flows, industry data collection and enrollment reporting methods, and more< Less
Health Reform Perspectives: Mobilizing Payor Business and Technical Architecture By Salus One Ed
eBook (PDF): $99.00
This 235-page knowledge guide provides the reader with the core information required to understand the underlying theory, working processes, and necessary infrastructure to enable and implement... More > strategic management capabilities including: -internal and external core regulatory compliance requirements - alignment of existing tactical program and project management methodologies to proactive multi-year business, clinical, and technology initiatives - how to obtain moderate knowledge of ‘blueprinting’ across initiatives in the health insurance vertical - knowledge to manage multiple initiatives via Architecture Review Boards (ARBs) and Technical Review Board (TRB) governance - enablement of prototypical industry-standard payor system and process flows, - acceleration of innovation (e.g. build vs. buy) and anticipation of future business needs - and much more...< Less
Big Clinical Data and Health Insurance: Managing Large Clinical Data Sets for Optimal Outcomes By Salus One Ed
eBook (PDF): $79.00
This 278-page knowledge guide provides the reader information required to understand the underlying theory, working processes, necessary infrastructure to enable and implement modernized enterprise... More > clinical data capabilities including: - internal and external core regulatory compliance requirements - support for providers, members, and vendor partners and their respective inquiries and requests - outcomes and performance needs including clinical and cost-based measures - multiple data submission methods (i.e. employer, independent), - typical individual and group performance activities prototypical commercial payor system and process flows, - industry data collection and enrollment reporting methods, and - much more...< Less

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Our World Our World By Deleah Payne
Paperback: $21.60