Our Services
Southwest Medical Consulting provides strategic managed care and healthcare consulting services to physician groups, healthcare organizations, and health plans. We deliver practical, results-driven support designed to improve performance, strengthen payer relationships, and support sustainable growth.
Our services are customized to meet the unique operational, financial, and strategic needs of each client.
Managed Care Contracting & Negotiation
We support organizations throughout the managed care contracting lifecycle—from strategy development to negotiation and ongoing management.
Our services include:
- Contract review and analysis
- Negotiation strategy and payer positioning
- Reimbursement optimization and risk assessment
- Contract compliance and interpretation
- Ongoing contract performance monitoring
Our goal is to help clients secure fair, sustainable agreements that align with organizational objectives and operational realities.
Network Development & Strategy
Strong provider networks are essential to performance, access, and compliance. We help organizations design, expand, and optimize networks that meet payer, provider, and patient needs.
Our services include:
- Network development and expansion strategy
- Provider recruitment and onboarding support
- Network adequacy and compliance review
- Payer network alignment
- Ongoing network optimization
We work closely with stakeholders to ensure networks are both operationally effective and strategically positioned.
Managed Care Help Desk Services
Our Managed Care Help Desk provides ongoing support to address day-to-day managed care challenges and payer interactions.
Our services include:
- Contract interpretation and issue resolution
- Payer communication and escalation support
- Claims and reimbursement issue guidance
- Operational support for managed care teams
- Ongoing advisory services
This service allows internal teams to focus on core responsibilities while ensuring managed care issues are addressed efficiently and accurately.
Operational & Strategic Consulting
We partner with organizations to identify opportunities for improvement and guide informed decision-making across operations and strategy.
Our services include:
- Operational assessments and workflow analysis
- Performance and utilization review
- Strategic planning support
- Process improvement initiatives
- Leadership and advisory support
Our approach is collaborative, data-driven, and focused on delivering measurable results.
NEW SERVICE: Self-Funded Health Plan Consulting
We work with self-funded health plans to help them manage costs, improve plan performance, and align vendor relationships with their strategic goals.
Southwest Medical Consulting provides objective guidance and hands-on support to employers, plan sponsors, and organizations operating in the self-funded space.
Our services include:
- Vendor evaluation and management (TPAs, PBMs, networks, specialty vendors)
- Contract review and negotiation support
- Plan design and cost-containment strategy
- Network and provider alignment
- Ongoing advisory support and performance monitoring
We help self-funded plans gain transparency, control costs responsibly, and make informed decisions that support both financial sustainability and member outcomes.
Let’s Talk About Your Needs
Whether you’re navigating managed care challenges, optimizing contracts, strengthening networks, or managing a self-funded health plan, Southwest Medical Consulting is here to help.
Contact us today to discuss how our services can support your organization’s goals.
👉 Request a Consultation
