Expert answer:CEO Decision

Solved by verified expert:CEO of an insurance. There are complaints and now you have to investigate. PLESE ATTACHED WITH FULL SCENARIO & IT MUST BE IN APA CITATIONS. Use research to back up the solution. 750 WORDS or more required for this essay. Must have the following: INTRODUCTIONANALYSIS OF THE PROBLEMRECOMMENDED STRATEGY CONCLUSION WORKS CITED
instructions_week_2_.docx

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WEEK 2: YOU DECIDE
Southside HMO
Scenario/Summary
You are the chief executive officer of Southside HMO, which serves 495,000 members
throughout the eastern region of the United States. It has come to your attention that
several members or patients who participate in your plan have filed a complaint that
your HMO plan does not provide quality healthcare delivery. Several patients have been
denied healthcare services to see specialists to whom they were referred by their
primary care providers.
Your Role/Assignment
The board of directors has asked that you provide a 750-word report detailing your
strategies and recommendations to investigate the complaints and to identify strategies
to ensure that quality management initiatives are in place to make sure that quality
healthcare services are provided to all members. The strategies and recommendations
should be as specific as possible and include the resources needed for implementation.
Your primary text and journal and website research must be used as a reference to
support your analysis.
Key Players
Review the points of view of the following people to obtain further insights on this
assignment.
Dr. Waters Primary Care
I have been providing healthcare to patients at Sunnyside Hospital
for 5 years, and the hospital recently started contracting in network with Southside
HMO. Southside is denying referrals to specialists for medical treatment.
Mrs. Brown Patient Advocacy Group Representative Sunnyside
Hospital
I represent patients at Sunnyside Hospital, and more than
30 patients have informed me that Southside HMO is not complying with primary care
provider referrals to see a specialist.
Mr. Robins Mr. Robins CEO Southside HMO
I have been the CEO of Southside HMO for 10 years, and I
ensure that our organization is in compliance with all quality management initiatives.
Category
Points
%
Description
Content
10
20
Content is excellent, completely consistent, and appropriate for audienc
integrity; detail is rich and specific.
Organization
10
20
Organization is excellent; ideas are clear and arranged logically and the
Design and Format
10
20
Document format is excellent, with strong visual impact, design, and fo
Style and
Readability
10
20
Readability is excellent, with strong attention to audience, appropriate t
is good use of figurative language.
Grammar and
References
10
20
Grammar, referencing, punctuation, mechanics, and usage are correct a
English; content demonstrates competent use of mechanics.
Category
Points
Total
50
%
Description
A quality paper will meet or exceed all of the above requirements.
…
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