Project Red (Molina Clinical Services) - Waves 1, 2 & 3
Outsourcing of Advanced Imaging (Prior Authorization function) will take place in 2 -3 phases, with the first phase scheduled to begin in June 2019. Timing of phase 2 and/or 3 is TBD. Impacted staff include, RNs, Care Review Clinicians /Processors and some Medical Directors (approximately 114 FT/PT staff impacted, mostly in CA and some working remote out of state---AZ, CO, FL, MI, NV, OH, TX & UT). Reasons for outsourcing include. Better TAT, lower cost of processing Utilization Mgmt. requests, increase member satisfaction due to quick TAT decisions, ability to leverage automated tools such as a portal that provides immediate feedback on authorization requests that meet medical necessity criteria for approval