Delegated Utilization Management

End-to-end UM as a delegated entity. We operate under your policy framework, meet audit expectations, and provide transparent, auditable decisions and reporting.

Delegation Agreement

Scope, lines of business, criteria governance, reporting, and audit language aligned to accreditation.

Operations & SLAs

Intake, triage, review intervals, P2P orchestration, lettering, and handoffs back to plan ops.

Oversight & QA

Inter-rater reliability, periodic audits, corrective action plans, and issue management.

Data & Reporting

Volume, TAT, outcomes, appeals, and UM trend analytics delivered on a fixed cadence.

URAC / NCQA

Aligned oversight

Audit-ready

Time-stamped trails

Policy-driven

Medical necessity

Member impact

Escalation guardrails

Delegate with confidence

We operate to your policy, criteria, and SLAs — with transparent reporting and oversight.

Contact the Coordinate Team