Conduent’s Utilization Management solutions ensure that medical care for injured workers is appropriate, cost-effective, and medically necessary. In 2019, they non-certified 41 percent of preauthorization requests, saving $190 million through medical savings and modifications. Services include prospective, concurrent, retrospective, and expedited utilization reviews coordinated by nurses under a national medical director, along with clinical peer reviews by board-certified physicians. Drug Utilization Review addresses overuse, abuse, and cost control with formulary management, pharmacy analysis, and chronic medication protocols. Accredited by URAC since 2006, Conduent delivers unbiased, standards-based recommendations and integrated case management.

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