Toney Healthcare

We’re Growing – And We Need YOU! We’re not just hiring—we’re bringing in top talent, fostering growth, and empowering individuals to make a real impact. This is your chance to contribute, innovate, and help shape the future of our team and the work we do to support health plans and improve the lives of the members they serve. 👉 Check out our open positions and apply today: https://lnkd.in/eh_DuFQi

With CMS’ Final Rule pushing for #priorauthorization automation by 2026, AI-driven solutions are becoming the standard. But without a robust audit process, compliance and accuracy can suffer. At Toney Healthcare, we help health plans stay ahead with comprehensive prior authorization audits, covering routine, auto, and AI-driven approvals to ensure efficiency, compliance, and reliability. Health plans need partners who adapt to their needs—not one-size-fits-all solutions. ➡️ Learn more: https://lnkd.in/e9bHXDJF

💥 We’re Hiring! 💥 Sharing this exciting opportunity – we’re looking for talented professionals to join our team, including Utilization Management (UM) Nurses! If you or someone you know is interested in making an impact in healthcare, check out the original job posting below and apply today. Let’s grow together! #NowHiring #HealthcareJobs #UMNurse #JoinOurTeam #CareerOpportunities #toneyhealthcare

#NowHiring! We’re growing and looking for passionate professionals to join our team. If you’re looking for a role where your work makes a difference, explore our open positions: 📍 Credentialing Specialist – Coral Gables, FL 📍 LTSS Service Coordinator Level 1 – Southeast Houston, TX 📍 Utilization Management Nurse - Remote Help shape better health experiences. Learn more and apply here: https://lnkd.in/eh_DuFQi. ➡️ Know someone who might be a great fit? Feel free to share!

Don't miss Betsy Seals, CEO of Alerion Advisors, break down the future of #MedicareAdvantage and the biggest industry challenges ahead in a new podcast. Listen now: https://shorturl.at/MJLly

The Health Care Compliance Association (HCCA) Conference reinforced a clear message: #UtilizationManagement and #PriorAuthorization are under increasing scrutiny. With CMS intensifying oversight, health plans must be proactive, compliant, and audit ready. At Toney Healthcare, we help health plans optimize UM & Prior Authorization workflows, reduce compliance risks, and strengthen audit readiness. Need clinical staff in a pinch? We can help! ⬇️ Scroll below for the top compliance takeaways you need to know!

How can smart #UtilizationManagement save your health plan millions? Toney Healthcare’s expert team helped a health plan save over $1.02M in just one month across two hospitals—boosting efficiency while ensuring quality care. Learn how we deliver real results: https://hubs.la/Q02q3hsD0 #ClinicalStaff #ValueBasedCare

When a national health plan’s #UtilizationManagement (UM) department was underperforming, Toney Healthcare stepped in to turn things around. By leveraging our UM expertise and best-practice operational strategies, we delivered measurable improvements in efficiency, accountability, and compliance. 👉 Read the full case study: https://hubs.la/Q02jmc8c0 #HealthcareEfficiency #Compliance #OrganizationalTransformation

At Toney Healthcare, we’re dedicated to helping organizations improve how they implement, manage, staff, and grow critical healthcare programs like #UtilizationManagement, #CareManagement, and Appeals and Grievances. 🚨 New State Law Alert: AI-generated coverage decisions will need to be reviewed by a physician in California in 2026. While AI can drive efficiencies at the nurse review level, physician experts are essential for signing off on these decisions. This aligns perfectly with our physician review services, ensuring compliance, accuracy, and quality outcomes. Our In-Source Partnerships are designed to: ✅ Optimize utilization management ✅ Streamline physician review services ✅ Support appeals and grievances processes ✅ Drive better outcomes 💡Learn how our services address critical industry needs: https://hubs.la/Q02lmN2z0 #HealthcareInnovation #PhysicianReview #Appeals #Grievances #AI

We’re excited to be part of the Alerion Advisors family, collaborating with industry leaders to deliver innovative healthcare solutions and continue making a meaningful impact for our clients and their members. Learn more about our vision ➡️ https://shorturl.at/h7kim