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ROSE Consulting Group

RGA's ROSE® Consulting Group fills a critical need in meeting the challenges of today’s dynamic healthcare environment.

Our consultants offer an array of industry-leading services and resources to manage complex claims, enhance operational efficiency, and improve patient care.

ROSE was the first medical management consulting program in the reinsurance industry, and the program’s longevity is a testament to its effectiveness. Value comes from experience, and at ROSE we continually innovate first-in-market solutions that mitigate our clients’ exposure to costly claims.

ROSE Medical Risk Consultants are seasoned managed care professionals who partner with you to develop strategies to manage catastrophic and other high-cost claims. ROSE services include:

  • Case management consulting for clinically complex patients.
  • Comprehensive reviews of clients’ medical management operations.
  • Access to practicing physician specialists for individual case reviews and other program-related inquiries.

For a complete list of services, please contact ROSE@rgare.com.

ROSE has the extensive relationships, resources and knowledge to match each health organization’s unique claim challenge with a qualified vendor to maximize savings. With ROSE, clients gain access to:

  • Specialty pharmacy solutions
  • Transplant and other specialty networks
  • Air ambulance network and negotiation services
  • Claim negotiations and re-pricing
  • NICU levels of care consultation and training
  • Oncology cost containment resources
  • Dialysis and renal disease cost containment solutions
  • And so much more
Clients can utilize these resources at various points in the claim process, and at competitive rates. For a complete list of services, please contact ROSE@rgare.com.

One of the most effective ways to manage costs, while ensuring members receive the care they need, is to educate and empower our clients’ staff. ROSE has developed a robust curriculum of complimentary educational opportunities. These resources are essential to helping clients stay abreast of healthcare trends, control risk and improve patient outcomes. Clients can learn from experts through bimonthly webinars, case management guides on frequently encountered complex medical conditions, market research surveys and other publications exclusively for ROSE clients and available at our ROSE portal. Nursing and case management credits are available through the conference, webinars and ROSEBUD training on our ROSE portal.

For a complete list of services, please contact ROSE@rgare.com.

ROSEBUD is an NCQA-accredited case management program. Since 1985, ROSEBUD’s expert perinatal and neonatal nurse consultants have helped clients reduce the costs associated with high-risk pregnancies and infants through dedicated case management.  From general screening for all pregnant women to shortening NICU stays for infants with complex needs, ROSEBUD promotes the best interests of the patient and the health organization.

Upon referral from the health organization, a ROSEBUD RN works directly with the plan member to support the provider’s plan of care, and to educate her on achieving a healthy pregnancy and the care issues related to premature or ill infants. Our consultation services include:

  • Complimentary case management for perinatal and neonatal members

  • Incorporation of national guidelines into internal policies and procedures NICU levels of care assessment.

  • Staff training on perinatal and neonatal assessment and management

  • Assistance in implementing an NICU levels of care program to contain neonatal costs by ensuring appropriate levels of care are being billed and reimbursed

To learn more about the ROSEBUD, contact ROSE@rgare.com

Case Mgmt 3 yrs New Seal

Average Annual Outcomes Over the Last 10 Years
  • More than $16 million in total client savings
  • $201,800 in average savings per client
  • $6.32 : 1 ROSEBUD ROI
  • 1,250 continuing education credits granted