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AliCare | Utilization Management

Our Utilization Management programs provide professional medical oversight designed to promote optimal medical outcomes through appropriate utilization of medical resources. Our program includes hospital and medical pre-certification, concurrent and retrospective review, as well as discharge planning.

Our Utilization Management programs are:

  • Staffed and coordinated by registered nurses and physicians covering the full range of clinical services and settings – including specialty programs.

  • Designed to focus on the medical appropriateness, requested-setting, level of care and quality of care. Customization is available depending on the client’s needs.

  • Available on a 24 hour basis and can be “wrapped around” an existing program for night, weekend and holiday coverage.

  • Accredited pursuant to URAC standards.

  • In full compliance with the Department of Labor (DOL) standards for ERISA self-funded groups.