Prior to beginning work on this discussion forum, review the following:
Chapter 6: Sales, Governance, and Administration
Quality Indicators Associated With the Level of NCQA AccreditationDownload Quality Indicators Associated With the Level of NCQA Accreditation
Health Insurance: Changing Healthcare With Aetna (CXOTalk #317)Links to an external site.
Group Health Insurance ExplainedLinks to an external site.
Health Plan AccreditationLinks to an external site.
For this discussion forum, you are taking on the role of the human resources director in a large health system. Your CEO is unhappy with the current health insurance company due to their poor member services and claim processes. You are tasked to find another company that provides excellent member services and timely claim processes. Your benefits consultant, who represents several insurance companies, is on Family and Medical Leave (FMLA) for 2 months. You decide to search online and locate a top-rated health insurance company (e.g., UnitedHealth, Aetna, etc.). Using the health insurance company that you found, compile the critical information about what they offer to make an informed choice.
In your initial post,
Describe the member services of the health insurance company you found online (e.g., UnitedHealth or Aetna).
Discuss current or upcoming technology that benefits plan members.
Examine the member’s outreach program and incentives for wellness and prevention.
Identify its accreditation or certification, and its commitment to excellence and quality.
Generate at least one suggestion to improve the company’s member services or website.
Your initial post should be at least 500 words. Support your response with a minimum of two credible sources published in the last 5 years. Your sources must be formatted according to APA StyleLinks to an external site. as outlined in the Writing Center. The Scholarly, Peer-Reviewed, and Other Credible SourcesLinks to an external site. table offers additional guidance on appropriate source types.
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