Chronic Care Improvement Program (CCIP)
Implement and enhance Chronic Care Improvement Programs (CCIP) to drive better health outcomes, reduce costs, and improve Star Ratings
Our Clinical & Quality Improvement Solutions
At Rebellis Group, we specialize in clinical operations, strategy, and process improvement to enhance quality improvement, utilization management (UM), and medical management programs. Our team of experts provides comprehensive consulting services tailored to the unique needs of Medicare Advantage, Medicaid ACA plans and their vendor partners, ensuring compliance, efficiency, and superior patient outcomes.
Whether you're building a program from the ground up or refining existing processes due to regulatory changes or strategic shifts, Rebellis Group has the expertise to support your success.
Case Management Program Development
Design and optimize case management programs to improve member engagement, care coordination, and cost efficiency within Medicare Advantage, Medicaid, and commercial health plans.
HEDIS Assistance & Staff Support
Ensure compliance and optimize HEDIS measures with expert guidance, staff training, and performance improvement strategies.
Model of Care Development & Audit Readiness
Develop and refine your Model of Care (MOC) to meet CMS and NCQA standards while ensuring audit readiness for Medicare Advantage Special Needs Plans (SNPs).
Chronic Care Improvement Program (CCIP)
Implement and enhance Chronic Care Improvement Programs (CCIP) to drive better health outcomes, reduce costs, and improve Star Ratings.
NCQA & URAC Accreditation Assistance
Navigate the complexities of NCQA and URAC accreditation with expert guidance to strengthen your quality improvement programs and achieve compliance.
Clinical Decision-Making in Appeals & Organization Determinations
Optimize clinical decision-making processes within organization determinations and appeals, ensuring regulatory compliance and alignment with CMS audit protocols.
Utilization Management (UM) Policies & Procedures
Develop and refine utilization management policies and procedures to ensure effective cost containment, medical necessity reviews, and regulatory compliance.
Quality Improvement Program (QIP) Development & Redesign
Enhance your Quality Improvement Program (QIP) by identifying gaps, improving clinical workflows, and implementing data-driven quality strategies that elevate Star Ratings and member satisfaction.
Why Choose Rebellis Group?
✔ Deep expertise in clinical operations, medical management, and regulatory compliance.
✔ Proven experience working with Medicare Advantage plans, Medicaid programs, and commercial insurers.
✔ A tailored approach to quality improvement and utilization management.
✔ Audit readiness support to ensure compliance with CMS, NCQA, and URAC standards.