The Challenge
Cut medical management costs
- Staffing challenges in the Utilization Review unit due to turnover and aging workforce
- High cost of recruiting, training, and retaining nurse reviewers to support the case volume
- Limited workspace for additional nurses in the Utilization Review unit
The Solution
Create a dedicated clinical team for Utilization Review and Intake Coordination
- Utilize the “Train the Trainer” approach for scalability
- Implement Shearwater’s Quality infrastructure with a focus on Six Sigma Business Excellence
The Strategy
Utilization Review
Intake Coordination
"Train the Trainer" Program
Six Sigma Business Excellence
The Results
10X
Team Growth scaling from 6 clinicians to 60
98%
Quality Assurance Scores
33%
Increase Productivity Rates
99%+
Turn Around Time Compliance
