AI and the state of utilization management: Lessons for health plans


Thursday, July 17th, 2025 | 1:00 PM - 2:00 PM CT

Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom.

This webinar breaks down new national research on UM practices across payer organizations, offering a clear-eyed view of what's working, what's not and where change is most needed.

Leaders will also explore how AI-assisted technologies could help health plans get ahead of future interoperability challenges, including those tied to CMS-0057.

Key insights include:
 
  • Where UM processes are breaking down across health plans and care settings
  • How AI-assisted tools could reduce delays and improve alignment now and in the future
  • Real-world takeaways to improve speed, transparency and readiness ahead of CMS-0057

Presenters:

Ken young - McKenzie Patrick

Kenneth Young

CEO, Medecision

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Angela Moemeka, MD, MBA

Chief Medical Officer, Government Programs, HCSC

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Cameual Wright, MD, MBA

President, CareSource

Thomas

Thomas MacMillan

Chief Operating Officer, Emblem Health

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Craig Hersh, MD

Chief Medical Officer, Commercial, BCBS Florida