Utilization Review Technology and Optimization Partner (URT)

JPS seeks proposals for an AI-enabled Utilization Management (UM) solution that integrates with Epic and related enterprise systems to support timely, consistent, and prioritized UM review across inpatient and observation encounters. The solution should analyze available clinical, utilization, payer, authorization, and encounter data to generate actionable, explainable recommendations for admission status review, continued-stay review, payer authorization needs, and physician advisor escalation. The goal is to improve review timeliness, status accuracy, regulatory compliance, revenue integrity, and throughput by moving UM workflows from primarily manual queue review to intelligent, risk-stratified prioritization.