Virtual Operations Manager (VOM) 

Continual and Automated Monitoring of CMS Transactional DatA Using Your Own Data 

Beacon's Virtual Operations Manager allows plans to effectively determine the quality and efficiency of their plan’s operations system, its process, and procedures all within a secure platform. Beacon's Virtual Operations Manager is the ONLY industry solutions that imports a Plan's operational data, such as enrollment and disenrollment transactions, on a daily basis. VOM enables plans to monitor the status of their data. Not only can VOM help your operations run more effectively and efficiently, it will increase your bottom line! Let us show you how!

KEY BENEFITS

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  • Imports CMS standard files, PDE's and membership from your plans member system

  • Contains integrated rules engine that processes our proprietary audit points

  • Runs 100% of your operational data against our rules to identify any areas of risk

  • Allows you to decide the sample size and frequency

  • Shows risk areas with dashboard reporting

  • Performs automated reviews of your plan’s data to identify any areas of non-compliance

  • Provides a single source of truth for plan compliance and data

  • Tracks all steps performed to resolve compliance exceptions

 


HOW VOM WORKS:

THE 5 RULE PACKS INCLUDED:

The Health Plan’s transactions are run against our proprietary Rule Pack and when it doesn’t align with the expected response, VOM identifies the event requiring intervention.

Once a Corrective Action is created, VOM allows users to: 

  • automatically recommend next steps to correct

  • help you manage the work and create resolutions

  • report where the problems are coming from

  • gauge your operational goals

  1. Enrollment which allows users to identify transactions that are:

    • currently out of their timeliness requirement

    • at risk of being out of their timeliness requirement

    • incomplete or inaccurate

  2. Claims and Authorizations

  3. Appeals & Grievances

  4. Part D

  5. Sales & Marketing