RM (Results Management)
UM
Company Scoop
Alphabet Soup
The Pop Culture Clinic
100
This RM deliverable transforms raw data into meaningful insights for market partners identifying trends in performance.
What is a deep dive?
100
This request is submitted before a service takes place to confirm it's medically necessary.
What is prior authorization?
100
This company began as a single health and beauty store in 1963 in Lowell, Massachusetts, long before evolving into a healthcare giant.
What is CVS?
100
This three‑letter acronym stands for a major retail healthcare company known for pharmacies, MinuteClinics, and its partnership with Aetna.
What is CVS (Consumer Value Stores)?
100
This iconic medical drama made “McDreamy” a household name and highlights the fast-paced decisions clinicians face
What is Grey’s Anatomy?
200
This automation tool helps streamline the deep dive process for Senior and Associate Managers—reducing manual effort.
What is a macro?
200
This review occurs while a patient is receiving treatment, often during an inpatient stay.
What is a concurrent review?
200
This health insurer gets its name from a famous active volcano in Europe, chosen as a symbol of strength and stability.
What is Aetna?
200
This medical acronym refers to a detailed imaging scan that uses magnets—not radiation—to capture views inside the body.
What is and MRI (Magnetic Resonance Imaging)?
200
In the Marvel universe, this genius billionaire hero frequently needs post‑battle care — proving even superheroes would benefit from strong network coverage.
Who is Iron Man?
300
This RM metric reflects how much meaningful work is completed compared to time available, often expressed as a ratio or percentage.
What is percent productivity (% productivity)?
300
This healthcare process ensure members get medically necessary and cost-effective care by reviewing treatment plans, using evidence-based criteria before, during, or after services, controlling costs, and improving quality through mechanisms like prior authorization or quantity limits
What is utilization management?
300
In 1966, Aetna made history by paying the first claim for this federal insurance program.
What is Medicare?
300
In workplace chats and texts, this acronym lets others know you’ll return shortly.
What is “BRB" (Be Right Back)?
300
Doctors consistently praise this comedic hospital series as the most accurate depiction of real medical training, teamwork, and emotional challenges
What is Scrubs?
400
Held monthly, this recurring meeting brings markets together to review performance stats, emerging trends, and actionable insights that guide strategy and next‑step planning.
What is a Market Meeting?
400
This clinician‑to‑clinician conversation allows a requesting provider to discuss the case directly with a plan’s medical reviewer to change the outcome of a case.
What is a Peer to Peer?
400
This in‑store clinic network, expanded access to convenient, walk‑in healthcare across the U.S.
What is MinuteClinic?
400
This acronym expresses relief at the end of the workweek. (and a Katy Perry Song)
What is “TGIF" (Thank God It’s Friday)?
400
This workplace comedy follows the daily chaos inside a paper company in Scranton, where meetings often go off the rails
What is The Office?
500
These two individuals recently joined the RM team as Analysts and play a key role in supporting insights, reporting, and market deliverables and your favorite RM Analysts
Who are Ariel and LaRonda?
500
This type of reviewer—usually a physician—makes clinical determinations when cases require deeper medical judgment.
What is a medical director?
500
Name this person
Who is David Joyner?
500
This type of health plan encourages members to use in‑network providers and typically requires a primary care doctor for referrals.
What is a "HMO" (Health Maintenance Organization)?
500
In this series, doctors use a “tricorder” to diagnose patients instantly—technology healthcare teams today would love for streamlining assessments and reducing turnaround times.
What is Star Trek?