Anyone in utilization review being laid off, if so which teams?
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@124m+1jkkxzj23 - The Ford Pinto. Profits will always win. Fallout is the next persons problem.
@jx This is not entirely accurate about 80% UM reviews are AI or offshore. There might be UM reviews that are processed by AI or offshore, however those are a basic review not requiring nurse or MD reviews. This is especially true for all government business where there are Fed and State laws/rules that have to be adhered to. AI cannot be involved in the intricate notations that must be read by a human being and offshore is more for IT-related functions. Perhaps in 20 years from now AI might take over at 80% but I highly doubt it. There are too many intricacies with human beings and health-related issues whether it be physical or mental health. I guarantee the first time we all allow AI to take over the health of humanity, and it makes a mistake causing someone to die will be a total reboot of the idea of AI and humanities health.
@dd+1jkkxzj23 - "Likely 80% of all UM reviews will be AI or offshored."
It was recently shared that one of the new 'core competencies' at Elevance Health is "Investing in our talent. Advance, mobilize, and retain key talent that is fit for purpose with our evolving business needs."
It appears they won't be retaining much US-based UM talent. The talent must reside in other nations that have much warmer climates.
That’s because you in case management are being offshore to the Philippines. Carelon global solutions has taken over
I was laid off in utilization review on 1/28/25. Almost half my team was.
I don’t want to say too much but AI and offshoring is the theme for all forms of UM review. It’s not a matter of if, it’s a matter of when. Likely 80% of all UM reviews will be AI or offshored.
Also, How about psccr? Anyone know?