Our Expertise
NRM has extensive experience in financial monitoring for publicly funded healthcare programs.
Our team applies financial modeling, data analysis, and regulatory expertise to provide oversight solutions that help keep programs financially stable and sustainable. We provide pro form a analysis, enrollment trend reports, claims lag analysis, and utilization reviews for prescription drugs and nursing services. These services give agencies, consultants, and contractors clear, practical insights. Through careful analysis and tailored reports, NRM helps clients improve transparency, control costs, and achieve better program outcomes.
Risk Management Consulting
● Commercial Insurance
● Income, Property and Liability Protection
● Worker Compensation
● Reinsurance
● Commercial Surety Bonds
Employee Benefits
Human Resource Consulting
● Group Medical and Life Coverage
● Group Disability Income Protection
● Supplementary Products (Dental, Vision, LTC, etc.)
● Executive Compensation
● Cafeteria Plans
● Stop Loss Placement
● 401(k), Pension, Financial Planning*
● Developing Employee Handbooks
● Conducting Employee Surveys
● Benchmarking
● Strategic Planning Services
Advocacy and Assistance (Personal Lines)
● Homeowners
● Automobile
● Life, Health and Disability
● Long-Term Care
Pro Forma Financial Analysis: Development of scenario-based financial models to support budget planning, rate setting, and evaluation of proposed healthcare policy impacts.
Enrollment Analysis (Monthly & Quarterly): In-depth analysis of Medicaid and CHIP member enrollment trends, risk pool composition, and forecasting to inform eligibility and budgeting strategies.
Claims Lag Reporting: Evaluation of claims processing timelines and lag patterns to enhance reserve management, improve financial planning, and optimize provider reimbursement cycles.
Prescription Drug Utilization Analysis: Detailed assessments of pharmacy claims to identify spending trends, cost drivers, and opportunities for formulary management and drug cost containment.
Nursing Services Utilization Analysis: Review of nursing service claims to pinpoint high-cost areas and recommend actionable strategies for service optimization and efficiency.
Subcontractor Management: Oversight and quality assurance for subcontracted vendors to ensure adherence to state/federal requirements and deliverable standards.
Healthcare Program Evaluation: Policy Support: Analysis and interpretation of program performance data to support Medicaid program design, operational improvements, and policy development.
Financial Compliance & Reporting: Ensuring data integrity, audit readiness, and regulatory compliance through structured financial monitoring and reporting processes.
DIFFERENTIATORS
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Proven Track Record with State and Federal Health Agencies: Successfully partnered with multiple agencies and consulting teams to deliver reliable, actionable financial insights for Medicaid, CHIP, and other healthcare programs.
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Expertise in Healthcare Finance and Policy: Deep domain knowledge in Medicaid financial structures, rate setting,program integrity, and regulatory compliance ensures accuracy and alignment with government standards.
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Specialized Analytical Capabilities: Advanced proficiency in claims lag analysis, prescription drug utilization, and proform a modeling allows us to identify trends, forecast costs,and support strategic planning.
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Strong Subcontractor Oversight and Quality Assurance: Robust processes for managing subcontractor deliverables and ensuring compliance with complex reporting standards and performance metrics.
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Data-Driven, Decision-Oriented Approach: We translate complex data into clear, impactful insights that directly support policymaking, cost containment, and healthcare equality improvement.
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Flexible and Responsive Service Delivery: Our team is known for responsiveness, adaptability, and a collaborative approach that ensures timely and effective support across diverse project scopes.