Unifying Utilization Management and Payment Integrity
Published:
September 22, 2025
While utilization management (UM) and payment integrity (PI) share the same goals – ensuring appropriate, high-quality care and payments – these vital functions are typically not aligned internally. These systems and data silos lead to redundancies, provider abrasion, and missed opportunities for improved selections and cost avoidance.
This webinar explores how forward-thinking payers are reimagining these functions, aligning them as part of a unified strategy. Learn how insourcing a clinical AI-powered platform can reduce vendor dependence, improve provider trust and satisfaction, and empower internal teams with greater efficiency and newfound transparency into the root causes of errors.
Meet the Speakers
Lalithya Yerramilli
Head of Payment Integrity Solutions
Lalithya Yerramilli
Head of Payment Integrity Solutions
Lalithya Yerramilli is a healthcare technology leader with over 20 years of experience driving innovation at the intersections of analytics, payment integrity, and care optimization. She founded Zigna AI, where she focused on bringing transparency and efficiency to healthcare reimbursement. Previously, she was a member of the executive leadership team at SCIO Health Analytics, leading a global analytics organization and driving growth to support a $1B pipeline. Lalithya holds a master’s in Engineering, Quantitative Finance, and Statistics from Rutgers University, and an undergraduate degree in Engineering from Osmania University.
Monique Pierce
Senior Director of Payment Solutions
Monique Pierce
Senior Director of Payment Solutions
Monique has 25+ years experience building and leading payment integrity teams. She has worked for both small start-up regional health plans like Oxford Health and Devoted Health as well as large national health plans like UnitedHealthcare. Monique also has extensive leadership experience in the vendor partner space including Optum, SCIO Health Analytics and EXL. Monique is known for her vision and ability to execute as well as her passion for metrics. Today, Monique is driving opportunities to improve claim payment by designing and developing a bridge between prior auth and claim reconciliation products at Cohere Health.
Attendees Will Learn About:
- How siloed UM and PI functions create unnecessary inefficiencies, duplicated work, and provider abrasion
- Strategies to reduce “black-box” vendor ambiguity and provider frustration by providing unprecedented transparency into the root cause of coding and clinical validation errors
- How clinical intelligence in PI can drive smarter case selection and earlier interventions–getting it right from the get-go and de-risking pre-pay reviews
- Why insourcing a clinical intelligence-backed platform is becoming a competitive payer advantage and driving greater provider satisfaction
