Utilization Management

Wexford Health’s comprehensive utilization management (UM) program balances clinical needs with efficacy of care. 

Our program offers clients the following benefits.

  • Provides independent medical review to help ensure clinically appropriate care
  • Addresses all phases of a patient’s offsite encounter
    • Prospective review occurs prior to a patient’s offsite specialty appointment or inpatient stay. By prior authorizing these non-emergent services, Wexford Health ensures that patients receive clinically appropriate care.
    • Concurrent review occurs throughout a patient’s hospital stay.
    • Retrospective review occurs after a patient’s hospital visit or other emergency care, to ensure the quality and appropriateness of the services provided.
  • Collegial Review – Using video and/or telephone conference calls, site clinicians and Wexford Health Medical Directors and UM Nurses confer to review the patient’s medical history and determine the most clinically appropriate and responsible approaches to inmate health care issues. 
  • Supports risk management by identifying and helping to defuse situations that may lead to litigation, and significantly reduces inmate patient litigation.
  • Confirms, tracks, and provides service completion documentation that appropriate specialty and inpatient care is delivered in a timely fashion
  • Generates scheduled, standard reports that allows comparison of client facilities with regional and/or national benchmarks
  • Offers clinical expertise for compliance with ACA, NCCHC, and other accreditation standards

Upcoming Events

In addition to the financial, educational, and career advancement rewards, a position with Wexford Health offers personal fulfillment, providing you with hands-on  opportunities to positively impact a truly disadvantaged population.   

We will be happy to meet with you to learn about your goals and discuss how we can help you achieve them.

Thank you for visiting our website and choosing to learn more about our company.  We look forward to hearing from you!

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Wexford Health Sources, Inc.



Wexford Health Sources, Inc.
501 Holiday Drive
Suite 300, Foster Plaza Four
Pittsburgh, PA 15220




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