Solutions / Medicare Advantage Medical Director
Manage risk and cost across a covered population — before it becomes a claim.
Value-based care means you're accountable for outcomes and cost across an entire covered population, not just an inpatient encounter. Prescient's continuous risk scoring helps identify high-risk members earlier, across every admission in your network.
What You're Up Against
Where Prescient fits
Identifying high-cost, high-risk episodes early enough to intervene
Coordinating advanced-illness identification with care management and utilization review
Demonstrating measurable impact on total cost of care to plan leadership
What This Role Tracks
Metrics Medicare Advantage Medical Directors watch
Illustrative — the specific metrics and cadence are configured to match your reporting structure.
A Day With Prescient
In practice
- Monday, 8:00 AMWeekly network risk review
Utilization and care management teams start the week with a prioritized view of members showing rising risk across the network's admitting hospitals.
- Monday, 10:00 AMCare management outreach
Prioritized advanced-illness worklist informs proactive outreach before an escalation turns into a high-cost claim.
- MonthlyCost-of-care review with plan leadership
Utilization patterns and risk concentration across admitting hospitals feed into total cost of care discussions with plan leadership.
Relevant Platform Pillars
Built on
Advanced Illness Identification
Find the patients who need a goals-of-care conversation — before a crisis forces one.
Learn moreHospital System Intelligence Layer
One risk layer across every unit, every EHR, every patient.
Learn moreNetwork-wide risk visibility for value-based care
A Medicare Advantage medical director's team used network-wide risk rollups to coordinate care management outreach across multiple admitting hospitals in the plan's network.
Frequently Asked