HEALTHCARE MANAGEMENT SERVICES
Healthcare management expertise
built around better outcomes.
We provide specialized clinical and operational professionals and scalable teams across care management, utilization management, behavioral health, pharmacy, and quality programs, helping healthcare organizations improve quality, efficiency, and outcomes.
BEHAVIORAL HEALTH SUPPORT
Support the people behind
behavioral health programs.
We provide specialized professionals to support behavioral health programs, coordinate care, and help organizations respond to complex member needs.
KEY AREAS OF SUPPORT
- Behavioral health case management
- Behavioral health care coordination
- Substance use programs
- Community programs
CARE & POPULATION HEALTH
Coordinate care.
Support healthier populations.
We support care and population health programs with experienced professionals who help organizations coordinate services, manage complex conditions, and respond to the needs of diverse populations.
KEY AREAS OF SUPPORT
- Medicaid and Medicare population management
- D-SNP, HIDE-SNP, and FIDE-SNP programs
- Field care coordination
- Case management
- Disease and chronic condition management
PHARMACY & PBM SUPPORT
Specialized expertise for
pharmacy and benefit programs.
We provide specialized pharmacy talent and operational support to help healthcare organizations manage pharmacy programs, support Medicare Advantage requirements, and strengthen pharmacy benefit operations.
KEY AREAS OF SUPPORT
- Specialized pharmacy talent
- Medicare Advantage pharmacy operations support
- Pharmacy benefit management support
QUALITY & RISK ADJUSTMENT SUPPORT
Strengthen quality.
Support accurate risk adjustment.
We support quality, reporting, and risk adjustment initiatives with specialized expertise that helps healthcare organizations address program requirements and focus on performance improvement.
KEY AREAS OF SUPPORT
- Medicare Advantage compliance support
- HEDIS and Star Ratings
- Clinical reporting and chart retrieval
- Quality and performance improvement
- Risk adjustment support
UTILIZATION & MEDICAL MANAGEMENT
Expertise for informed
medical management decisions.
We provide experienced clinical professionals and program support to help organizations manage utilization review, evaluate medical necessity, and maintain readiness for regulatory and accreditation requirements.
KEY AREAS OF SUPPORT
- Medical necessity review
- Prior authorization review
- Concurrent and retrospective review
- Physician review services
- Regulatory readiness
- Clinical program management
- NCQA and URAC compliance support
FEATURED INSIGHT
AI in healthcare requires more than technology
AI’s value in healthcare depends on more than the technology. Successful adoption requires the right governance, infrastructure, workflows, and specialized expertise.
HOW WE DELIVER
Tailored delivery built to meet your needs.
We align the right expertise and delivery model to your needs, whether you’re adding specialized talent, building a project team, or engaging a fully managed team.
Staff Augmentation
Expertise you can rely on.
Healthcare-experienced professionals backed by rigorous vetting, responsive support, and ongoing resource management throughout the engagement.
Team-Based Delivery
Increased flexibility.
Bring together multiple resources and skill sets within a flexible team structure, with service levels tailored to the needs of the engagement.
Managed Delivery
Ownership & accountability.
Walker Healthforce provides active team management, governance, and performance oversight, with defined service levels aligned to the engagement.
Increasing Walker Healthforce delivery involvement
Partnering
Built to work together.
Collaboration is embedded across every delivery model, aligning our expertise, communication, and approach to client priorities.