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Glossary Entry
Health Insurance > Insurance plan operations
Needs a little more detail
Subtopics:
Enrollment, premium accounting, claims, provider contracting, member services, sales/marketing, information technology, finance, accreditation, subcontracting (pharmacy, behavioral health, specialty care) and underwriting.
Learning Objectives:
Undergraduate
students should be able to
List the key operational functions of a health plan
Graduate
students should also be able to
Analyze key operational functions of a health plan for their impact on plan profitability
Analyze key operational functions of a health plan for their impact on member and provider satisfaction
Created By:
Gerod Blue
12-18-2012
Last Updated By:
Gerod Blue
12-18-2012
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