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2. Utilization management - Wikipedia

   en.wikipedia.org/wiki/Utilization_management

   Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

3. Case management (US healthcare system) - Wikipedia

   en.wikipedia.org/wiki/Case_management_(US...

   Utilization/Financial Management – managing resource utilization and reimbursement for services. Performance & Outcomes Management – monitoring, and if needed, intervening to achieve desired goals and outcomes for both the patient and the hospital.

4. URAC - Wikipedia

   en.wikipedia.org/wiki/URAC

   URAC's accreditation programs include specialty pharmacy, digital health, utilization management, health plan, case management, and others. [4] In order to earn an accreditation, organizations submit various policies and procedures which are reviewed by a nurse or pharmacist and then the Accreditation Committee. [5] Accreditation lasts for ...

5. Managed care - Wikipedia

   en.wikipedia.org/wiki/Managed_care

   Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.

6. Category:Nursing specialties - Wikipedia

   en.wikipedia.org/wiki/Category:Nursing_specialties

   Clinical nurse leader; Clinical nurse specialist; Correctional nursing; D. ... Utilization management; W. Women's health nurse practitioner; Wound, ostomy, and ...

7. List of healthcare accreditation organizations in the United ...

   en.wikipedia.org/wiki/List_of_healthcare...

   Utilization Review Accreditation Commission (URAC) Education accreditation ... Advanced practice nursing college accreditation. American College of Nurse-Midwives;