Utilization management teams need to turn reviews around quickly, keep them consistent and still be able to defend every decision. AI is beginning to reshape that work. Paired with clinical reviewers, AI can assemble unstructured patient data, align it against established care guidelines and surface an evidence-based recommendation.
This session brings in utilization management leaders from Telligen, an early adopter of an AI-enabled review approach, to walk through what deployment involved.
Learnings include:
- How AI paired with clinical oversight can improve review speed, consistency and defensibility versus traditional UM workflows
- What an early adopter measured across turnaround time, alignment with clinical indications and documentation transparency
- How to build governance and clinical oversight into an AI-enabled utilization management program
- Practical implementation lessons and plans for what comes next