A diverse group of clinicians with backgrounds in occupational medicine and pharmacotherapy help drive extraordinary results. Individually, they bring specialized knowledge of musculoskeletal injuries, pain management, alternative therapies, specialty drugs, managed care and other areas critical to workers’ compensation. We integrate their expertise into our best-in-class pharmacy and ancillary medical solutions. The clinical staff plays a significant role in shaping our cost management solutions. Their expertise enables our solutions to reach well beyond managing pharmacy and ancillary medical transactions to:
"The most important step in avoiding claim escalation is the ability to recognize and flag the patients that pose risks by leveraging our clinical experts, our technology and our analytics.”
– Silvia Sacalis, PharmD, VP of Clinical Operations, Healthesystems
Our clinical leadership apply evidence-based medicine to guide best practice in managing workplace injuries. And our staff of expert clinical pharmacists tap into their in-depth understanding of pharmacotherapy and nuanced understanding of workers’ compensation to deliver the most accurate clinical decision support.
Our clinicians work behind the scenes and alongside clients to ensure that utilization is well managed and injured workers receive appropriate therapies. Through robust clinical analytics, they identify risks and opportunities in claims populations and shape strategies and tools to intervene — often in partnership with our technology staff.
Our clinical staff guides payers through clinical decisions that affect overall program performance. They ensure that our solutions are proactive, flexible and reflect current evidence-based medicine protocols.
Our Pharmacy and Therapeutics Committee provides evidence based clinical guidance for plan design recommendations and continuous quality improvement initiatives.
Through our Clinical program, our clinicians provide a suite of specialized services integrated into our PBM solution. These services address the most pressing issues in workers’ compensation and enable us to best manage program and plan design.
Healthesystems was recognized for our commitment to maintaining quality standards and accountability. We meet the strict standards set by URAC, the health care accrediting organization that establishes quality standards for the health care industry and received full accreditation for workers’ compensation and property and casualty pharmacy benefits management.