Value Stream for a Health Plan ( HMO / PPO Model)

Value Stream for a Health Plan ( HMO / PPO Model) ()

Eligible members receive the right benefits, providers deliver care efficiently, claims are adjudicated accurately, and regulatory-compliant financial operations ensure sustainability.


End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)
Claims Adjudication & Payment
Provider Network Development & Management
Claims Submission & Intake
Marketing, Product & Benefit Design
Member Acquisition & Enrollment
Care Management & Utilization Management


		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Claims Adjudication & Payment
		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Provider Network Development & Management
		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Claims Submission & Intake
		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Marketing, Product & Benefit Design
		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Member Acquisition & Enrollment
		End-to-End Enterprise Value Stream for a Health Plan ( HMO / PPO Model)	Care Management & Utilization Management
		Provider Network Development & Management	Care Management & Utilization Management
		Claims Submission & Intake	Claims Adjudication & Payment
		Marketing, Product & Benefit Design	Member Acquisition & Enrollment
		Member Acquisition & Enrollment	Provider Network Development & Management
		Care Management & Utilization Management	Claims Submission & Intake