Services
Healthcare strategy and advisory services for health plans, vendors, health tech, and investors
Every engagement is led by a Registered Nurse and Board-Certified Case Manager with more than 20 years in managed care. We advise. Your team executes with our guidance, and we stay close to the work.
Signature offering
The Stars and HEDIS Strategy Blueprint
A fixed-scope engagement that applies the DAI Strategy Review to your plan. We assess your provider contracts, data, workflows, and measures together, then deliver your leadership team a prioritized strategy blueprint.
Who it is for: Medicare Advantage, Medicaid, and D-SNP plans that need a clear Stars and HEDIS strategy for the next measurement year.
Timeline: 8 to 12 weeks. Contact us to scope the Blueprint for your plan.
Ask about the BlueprintWhat you receive
- Upstream assessment of provider contracts, data flows, and clinical and operational workflows
- Measure-by-measure Stars and HEDIS priorities tied to cut points and weights
- Medical record review and supplemental data readiness review
- Twelve-month roadmap with owners, milestones, and measures of progress
- Executive readout for your leadership team
Signature offering
The 3-Week Rapid Assessment
Find what is holding performance back in three weeks, not three months. We review your documents and data, spend three to four days onsite working side by side with your team, and deliver prioritized findings you can act on immediately.
Who it is for: Plans and vendors that need a fast, independent read on Stars, HEDIS, accreditation, or clinical operations before they commit to a larger plan.
Timeline: 3 weeks. Contact us to schedule your assessment.
Ask about a Rapid AssessmentWhat you receive
- Prioritized findings ranked by impact and urgency
- Quick wins your team can act on right away
- Root causes traced upstream to contracts, data, and workflows
- Recommended next steps in a written PowerPoint presentation
Week 1
Review
We review your documents, data, policies, and performance results before we arrive.
Week 2
Onsite
Three to four days onsite with your team, observing workflows and testing what we found.
Week 3
Deliver
Final findings, quick wins, and recommendations, delivered in a written PowerPoint presentation to your leadership team.
Stars and HEDIS strategy
Quality performance is decided long before the measurement year closes
Who it is for: Stars, quality, and HEDIS leaders at MA, Medicaid, D-SNP, C-SNP, and Commercial plans.
01
Stars strategy
When your Star Rating is at risk or stuck below target, we build a measure-by-measure strategy tied to your operations, budget, and timeline.
- Multi-year Stars strategy and measure roadmap
- Measure prioritization tied to cut points and weights
- CAHPS and HOS member experience strategy
- Operational accountability and monitoring
02
HEDIS strategy and rate improvement
When rates stay flat despite more outreach, we build a HEDIS strategy that finds the operational causes and focuses effort on the measures with the most room to move.
- Annual HEDIS strategy and measure plan
- Root cause analysis by measure
- Provider engagement and incentive alignment
- Intervention design and tracking
03
HEDIS medical record review and data
Hybrid measures and incomplete data put rates at risk every season. We design the medical record review (MRR) program and fix the data capture behind it.
- MRR program design: chase strategy, abstraction workflows, and over-read
- MRR vendor selection and oversight
- Supplemental data and ECDS readiness
- Provider contract data requirements
- Digital quality measure transition planning
Clinical programs and accreditation
Programs that work for members and hold up in survey
Who it is for: Clinical, quality, and accreditation leaders at health plans and health care vendors.
04
Clinical program development
When a clinical program needs to be built or rebuilt, we design it to meet CMS, state, and NCQA requirements and to work in practice.
- Program design, including D-SNP and C-SNP Models of Care
- Policies, workflows, and staffing models
- Program evaluation and reporting
05
Accreditation
When an NCQA or URAC survey, renewal, or corrective action is coming, we assess against current standards, close the gaps, and prepare your team.
- Gap assessment against current NCQA or URAC standards
- Mock file review for UM, credentialing, and case management
- Policy development and survey preparation
Vendors and investors
A clinical view of the health plan market, from the inside
Who it is for: Health care vendors, health tech and AI companies, private equity firms, and investors.
See everything we offer private equity and venture investors06
Vendor go-to-market
MA, Medicaid, D-SNP, and Commercial buyers evaluate vendors differently. When you move into a new line of business, we help you adapt.
- Buyer and decision-process mapping by line of business
- Positioning, messaging, and evidence strategy
- Pricing strategy and sales cycle design
07
PE clinical due diligence
Financial models rarely show whether a target's clinical program will survive scrutiny. We test it before you close.
- Clinical program and outcome claim review
- Regulatory, compliance, and accreditation risk
- Quality performance validation
08
Investor clinical advisory
After the deal, we give investors and portfolio companies an ongoing clinical perspective on strategy, risk, and plan market fit.
- Clinical strategy guidance for portfolio companies
- Health plan market fit assessment
- Post-close care model integration planning
Compliance and clinical operations
Operations that meet requirements and protect members
Who it is for: Compliance, clinical operations, and medical management leaders at health plans and health care vendors.
09
Compliance
When audit findings or new requirements need a response, we interpret the requirements and help you build compliant policies, workflows, and oversight.
- Requirement interpretation and gap review
- Audit finding response and corrective action planning
- Delegation oversight of vendors, including AI vendors
10
A&G, care management, and UM
When clinical operations miss timeliness or quality targets, we review workflows, documentation, and decisions, then redesign what breaks.
- Appeals and grievances timeliness and documentation review
- Utilization management workflow and decision review
- Care management stratification and engagement design
Operations, engagement, and network
Execution is where strategy succeeds or fails
Who it is for: Operations, member experience, and provider network leaders at health plans and health care vendors.
11
Operational excellence
When operations are slow, costly, or inconsistent, we find the breakdowns and redesign workflows, metrics, and accountability.
- Process and workflow assessment
- Operational metrics and performance monitoring
- Process redesign and standard work
12
Member engagement
When outreach volume rises but outcomes do not, we design engagement that changes member behavior and moves measures.
- Engagement strategy by population and channel
- Measurement of engagement impact on outcomes
- Member experience and CAHPS alignment
13
Provider contracting and network
Quality, data, and cost performance depend on provider contracts and network design. We help plans align both with their quality goals.
- Provider contract review for quality and data requirements
- Value-based and incentive program alignment
- Network strategy and provider engagement
Leadership and organization
The right leaders in the right structure
Who it is for: Executives leading clinical, quality, and operations teams through growth or change.
14
Leadership development
When clinical and quality leaders need to grow into bigger roles, we develop them to run programs, teams, and change with confidence.
- Coaching for clinical and quality leaders
- Readiness for new or expanded roles
- Team capability building
15
Organization restructuring
When a clinical or quality organization needs a new structure, we redesign roles and accountability so the work gets done and stays done.
- Current-state structure and role assessment
- Target structure, roles, and accountability
- Transition planning
How we engage
Three ways to work with us
Advisory retainer
Ongoing senior access for strategy, review, and decisions as they come up.
Defined project
A fixed scope with clear deliverables, such as a readiness assessment or diligence review.
Hourly advisory
Targeted expert time for specific questions, reviews, or working sessions.
Common questions
Does Dueringer Advisors replace our internal team?
No. We advise and guide, and your team executes. Our goal is to leave your team stronger and your processes repeatable.
Who leads our engagement?
Tina Dueringer, BSN, RN, CCM, PCC, is hands-on in every engagement. Specialist consultants and partner firms from across the country join based on your needs, and Tina stays accountable for the work.
Do you name clients or share engagement details?
No. Client work is confidential. We do not name clients or publish engagement details, and we protect your information the same way.
Do you provide sales, introductions, or referrals for vendors?
No. We are an advisory firm. We help vendors design their strategy, and the vendor's team runs its own sales and outreach.
Do you provide legal advice?
No. We interpret regulatory and accreditation requirements from an operational and clinical perspective. Legal questions go to your counsel.
Can you work with plans that restrict outside AI tools?
Yes. Our work does not depend on AI tools. When a plan restricts them, we work within its systems and policies.
Which lines of business do you support?
Medicare Advantage, Medicaid, Dual Eligible Special Needs Plans, Chronic Condition Special Needs Plans, and Commercial.