Smarter Decisions. Smoother Transitions.

Clinician-Led AI: A Proven Human-in-the-Loop Approach to Smarter UM & Case Management

During this session, two utilization management and care coordination leaders will share how they responsibly harness AI to drive workflow efficiencies and strategic optimizations at their health systems. Attendees will discover how Carle Health System has achieved measurable improvements by implementing a clinician-led, human-in-the-loop framework that aligns UM and case management teams with their payer partners.

The panelists will showcase innovative ways their teams utilize AI—from leveraging generative AI for initial reviews to deploying predictive AI and machine learning to automate patient status determinations. This session offers valuable, real-world insights into successful AI implementation strategies that ensure smarter, more efficient approaches to UM and case management.