Credentialing Specialist at Innovative Management Systems, Inc. - City of Industry, California, United States
IMS delivers Practice Management and Administrative Services to individual physicians, group practices, FQHCs, and hospitals. IMS focuses on regulatory compliance, customer and provider experience, and measurable quality outcomes. IMS uses enhanced data analytics which enables the practice to regulate and improve overall medical spending, as well as the successful management of HEDIS and STAR measures. Maintaining current technology is critical in the managed care environment. The development of customized and automated reports will result in the ability to build provider protocols which will not only enhance the health care outcome of the member, but will allow our clients to maximize revenue compensation.With the consistent trend of a members financial risk shifting from the health plan to the provider, it is important to have an MSO team that understands the intricate concepts of managed care and is knowledgeable of health plan goals and regulatory requirements. The IMS team was carefully selected for their experience in the industry coming from a wide range of various nationwide health plans, California IPAs, and other MSO's. This collective experience and expertise enables IMS to thoughtfully establish best practice protocols based on previous lessons learned and proven models constructing an effective multi-payor environment.