Role of a Managed Healthcare Consultant

Stethoscope next to medical symbols Managed Health Care Consulting Certification from AIHCP

With increasing systems of complexity and calls for efficiency within healthcare delivery, the demand for those who can understand managed healthcare has never been more important. The Managed Health Care Consultant plays a key role in the delivery of high-quality and cost-effective care. This role continues to grow in importance and esteem.

For those committed to advancing their career, gaining advanced training and expertise in this sub-specialty is a route to national recognition and wider practice options. When you succeed and achieve certification status with AIHCP, you become a recognized specialist in managed health care which will enhance your marketable and aid you in cutting edge business skills.

This information reflects upon the significant advantages to pursuing a career as Managed Health Care Consultant Certification with AIHCP and explains how professional certification can attest your skills and open doors to new networks.

What is a Managed Health Care Consultant?

Managed care is an organized system of health care that attempts to manage the cost, utilization, and quality of a network of subscribers. The managed health care consultant is a key player within this system in achieving these goals.

Managed Health Care Consultants collaborate with hospitals, insurance companies, private practices and government agencies. Their main goal is to improve care quality while keeping costs down—a tightrope walk that demands a nuanced understanding of healthcare policy, financial strategies and clinical best practices.

This position calls for a combination of health care, medical expertise and managerial skill. Consultants interpret data, examine contracts, audit medical records and are able to provide a strategy for successful patient outcomes. They are the ones who can consult on care delivery models,  cost and quality initiatives , so providers can give their patients the best they can, given the financial limits of our current economy. They are specialists in managed health care models and are educators for organizations in meeting the rules and regulations of managed care organizations. They work in organizations as representatives to contracted managed health care companies ensuring effective on-ongoing partnerships. They carry out collaborative partnerships, and in working with managed care organizations are better able to inform their organizations  of changes and revisions to standards and regulations. Many work within the managed care industry in a variety of roles and positions to ensure the effective operations and goals attainment of those organizations. They may work for government agencies in facilitating managed care models for cost and quality initiatives. A Certified Managed Health Care Consultant is a health care professional with a diverse background grounded in theory/concepts of the managed care systems and models, as well as in health care finance and quality management and health care delivery. They are invaluable to the overall goal of the delivery of cost-effective quality care in complex health care systems today.

Benefits of Becoming Certified

  • Get National Visibility and Professional Respect. There are several important benefits to joining the ranks of Managed Health Care Consultant. In health, where excellence is all-important, it’s critical.  AIHCP offers the opportunity to earn a credential that will grant you the national visibility and respect necessary to flourish within this field.
  • Validation of Knowledge and Skills. You will distinguish yourself from other colleagues by achieving the standards of a certification in Managed Health Care through AIHCP. It is an indication to employers, clients and coworkers that you are possess both knowledge and skills related to managed care concepts such as utilization review, case management and quality assurance.
  • Moving Beyond Direct Patient Care. Patient care itself is rewarding, but it can be physically exhausting. Consulting is how you influence the quality of care on the larger scale without the daily grind of facing patients. As a Managed Health Care Consultant you are impacting whole populations of patients by optimizing the way care is delivered and coordinated.
  • Significant Increase in Marketability. There is a high demand for Managed Health Care Consultants that combines cost containment and quality improvement in the tight market of health care.
  • Advantages in Job Market. Having a certification as a Managed Health Care Consultant from AIHCP will enhance your resume and give you greater opportunity for employment within the field as well as advancement in your career.
  • Career Mobility and Flexibility. This role offers significant flexibility. Managed Health Care Consultant from AIHCP can work as freelancers, independent contractors, or may also be employed by consultancy firms as “senior consultants”. This flexibility enables you to mold your career around your life and professional desires. Whether you’re more of a corporate-life person or an independent consultant, you can take these skills and knowledge anywhere!
  • Financial Incentives and Earning Potential. Higher skill set usually results in higher salary. Higher salaries are correlated with higher positions earned through certifications.  Certification in Managed Health Care provides the expertise to recognize inefficiencies, and make performance-preserving cost reductions with proven returns on investment to an employer—justifying higher salary brackets/consulting fees for certified individuals.
  • Diversified Income Streams. Managed Health Care Consultants have more freedom to work independently with different facilities and hospitals..
  • Joining a Professional Network. Social isolation can impede career advancement. One of the benefits of certification is the membership of belonging with AIHCP and other like-minded professionals within the field of Managed Health Care.  Institutions such as the AIHCP offer a resource for professionals to connect with others in their field. The network is an invaluable resource for sharing tips, talking about what’s new in the industry and finding a mentor. Joining a professional group means connections that may result in jobs partnerships, referrals and work opportunities.
  • Continuing Education and Lifelong Learning. The healthcare landscape changes rapidly. There are always new rules, techniques and therapies that are developed within the field.  Continuing Education (CE) programs are offered by professional associations such as AIHCP to provide supplemental support. These programs help you keep up-to-date and maintain today’s standards of professionalism.

Ultimately, becoming a Managed Health Care Consultant can be a smart career choice for the ambitious healthcare professional. It is a promise to excellence, an avenue to leadership, and a powerful resource to enhance one’s education and career. You can request information on this program, and others that  AIHCP offers.