Case Management/Utilization Management Sample Clauses

Case Management/Utilization Management. Re-certification Denials for request Pre-discharge denials/appeals Denial overturn
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Case Management/Utilization Management. 7.1 BLUE CROSS may establish a Utilization Management (“UM”) program which shall seek to assure that Hospital Services or Medical services provided to Members are Medical Necessary. The Utilization Management shall follow the procedures described on Exhibit A attached to and made part of this Agreement. BLUE CROSS may change UM procedures by delivering amendments to, or a replacement for, Exhibit A. The BLUE CROSS Quality Management Committee shall be part of the UM program.

Related to Case Management/Utilization Management

  • Case Management Prompt resolution of any dispute is important to both parties; and the parties agree that the arbitration of any dispute shall be conducted expeditiously. The arbitrators are instructed and directed to assume case management initiative and control over the arbitration process (including scheduling of events, pre-hearing discovery and activities, and the conduct of the hearing), in order to complete the arbitration as expeditiously as is reasonably practical for obtaining a just resolution of the dispute.

  • Change Management BellSouth provides a collaborative process for change management of the electronic interfaces through the Change Control Process (CCP). Guidelines for this process are set forth in the CCP document as amended from time to time during this Agreement. The CCP document may be accessed via the Internet at xxxx://xxx.xxxxxxxxxxxxxxx.xxxxxxxxx.xxx.

  • Construction Management Landlord or its Affiliate or agent shall supervise the Work, make disbursements required to be made to the contractor, and act as a liaison between the contractor and Tenant and coordinate the relationship between the Work, the Building and the Building’s Systems. In consideration for Landlord’s construction supervision services, Tenant shall pay to Landlord a construction supervision fee equal to three percent (3%) of Tenant’s Costs specified in Section 7.

  • Project Management Project Management Institute (PMI) certified project manager executing any or all of the following: • Development of Project Charter • Development of project plan and schedule • Coordination and scheduling of project activities across customer and functional areas • Consultation on operational and infrastructure requirements, standards and configurations • Facilitate project status meetings • Timely project status reporting • Address project issues with functional areas and management • Escalation of significant issues to customers and executive management • Manage project scope and deliverable requirements • Document changes to project scope and schedule • Facilitate and document project closeout

  • Account Management 15.1 The Contractor is required to provide a dedicated Strategic Account Manager who will be the main point of contact for the Authority. The Strategic Account Manager will:  Attend quarterly, or as otherwise agreed, review meetings with the Authority, in person at the Authority’s premises or other locations as determined by the Authority  Attend regular catch-up meetings with the Authority, in person or by telephone/videoconference  Resolve any on-going operational issues which have not been resolved by the Contractor or Account Manager(s) and therefore require escalation  Ensure that the costs involved in delivering the Framework are as low as possible, whilst always meeting the required standards of service and quality.

  • Base Management Fee The Base Management Fee will be calculated at an annual rate of 2.0% of the Company’s gross assets, exclusive of cash and cash equivalents. The base management fee will be payable quarterly in arrears and will be calculated based on the average value of the Company’s gross assets at the end of the two most recently completed calendar quarters (and, in the case of our first quarter, our gross assets as of such quarter-end). The base management fee may or may not be taken in whole or in part at the discretion of the Adviser. All or any part of the base management fee not taken as to any quarter will be deferred without interest and may be taken in such other quarter as the Adviser will determine. The base management fee for any partial month or quarter will be appropriately prorated.

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