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UnitedHealth Group Inc. follows the Coordination operating model because they work together like a team to provide healthcare. They have different parts, like insurance and medical services, but they all cooperate to give complete healthcare solutions. Even though each part can make some decisions on its own, they all need to follow the plan of the company. They share information about customers and suppliers to make things work smoothly. Also, when they make technology decisions, they try to agree on what's best for everyone.
Level of Standardization and Integration:
A coordinated approach with a medium level of standardization and integration results in operational excellence for the UnitedHealth Group.
Standardization: To ensure consistency, the UnitedHealth Group has rules and guidelines. In particular, they use the same formats to share essential data such as information about members, healthcare providers, and costs among their different parts. They are likely to follow similar rules and regulations, e.g. about patients' privacy.
Integration: Different parts of UnitedHealth Group are probably connected in various ways. They likely share important data between units using a central system, making it easier to work together. Also, they probably use technology to link their systems and automate tasks.
Characteristics of Coordination
Business units have some independence but work together to achieve shared goals.
Business units are operationally unique but have shared customers, products, suppliers, or transactions that impact other units
IT infrastructure services are designed through consensus, while application decisions may be made within business units
Mind Map of UnitedHealth Group
Mind Map of UnitedHealth Group
1. Core Business Processes:
UnitedHealth Group's main focus is healthcare and well-being and the core business operations are connected with that. These include
Claims Processing: Effectively dealing with medical insurance claims - managing them as well as hearing the claims made.
Provider Network Management: Engaging and sustaining healers teamwork and partnership.
Health Care Delivery: Launching primary care networks and clinical operations including larger subsidiaries such as OptumCare using the tools and resources that ensure quality healthcare services for patients.
Data Analytics and Insights: Using data to enhance care management and disease prevention and steer high-risk patients away to proactive health.
2. Shared Data Driving Core Processes:
The information is a vital aspect of the UnitedHealth Group's functioning. Shared data drives core processes such as
Electronic Health Records (EHR): The management of sensitive patient information data in a secure manner.
Claims Data: Comprehending claims information to expose fraud and waste as well as finding ways to save costs.
Clinical Data: Assisting in decision-making about evidence-based healthcare approach.
Member data: It covers demographics, health previous, claims state as well as other information that is used to oversee health plans and running of the risks.
3. Key Linking and Automation Technologies:
UnitedHealth Group relies on advanced technologies to link and automate processes:
Health Information Exchange (HIE): Enabling barrierless data exchanges among healthcare sectors.
Electronic health records (EHRs): These systems allow for the secure sharing of patient data among various providers.
Claims processing systems: These are machine learning systems that credit the payments for health care claims.
Artificial intelligence (AI): It can be applied to the tasks of identifying and verifying patients based on their facial features, monitoring their vital signs, and diagnosing ailments, to name a few. Examples include fraud detection, claims processing, and chatbots for customer service.
4. Key Customers:
UnitedHealth Group serves a diverse set of customers: UnitedHealth Group serves a diverse set of customers:
Health Care Providers: With hospitals, clinics, and physicians collaboration is a must.
Pharmaceutical Companies: For research and drug pricing partnership.
Individuals: People who enroll in UnitedHealthcare plans for health insurance coverage.
Employers: Companies that provide plans to their people as part of employees' rewards or benefits package.
Core Diagram of UnitedHealth Group
Core Diagram of UnitedHealth Group
Process:
UnitedHealth Group focuses on healthcare and well-being, with core processes like claims processing, provider network management, healthcare delivery, and data analytics driving efficiency and improving outcomes.
Data:
UnitedHealth Group relies on shared data for key processes like managing electronic health records securely, analyzing claims for trends and fraud, supporting evidence-based care decisions, and managing member and provider information for efficient health plan management.
Technologies:
UnitedHealth Group utilizes advanced technologies for linking and automating processes, including Health Information Exchange (HIE), Robotic Process Automation (RPA), Telehealth Platforms, Big Data Platforms, and Electronic Health Records (EHRs). These tools streamline data exchange, automate repetitive tasks like claims processing, enable virtual care delivery, analyze large datasets for insights, and ensure secure sharing of patient data among providers.
Customers:
UnitedHealth Group serves individual members, employers, government programs, healthcare providers, and pharmaceutical companies by providing health insurance plans, collaborating on research, and administering government-funded health programs.
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