Leads aspects of Provider Network Management to include provider network management, provider support provider service, provider education, and provider compliance.
June 14, 2021
Demonstrate a thorough knowledge of Affinity and Network Department Policy and Procedures, and Provider Agreements, including, but not limited to, contracts for FQHCs, Hospital, IPA, Article 28 Primary, Specialty and Ancillary Care, Individual Primary Care Provider, and Individual Specialty Care Provider services.
June 25, 2021
Develop effective ongoing relationships with providers that result in convenient access, high quality, and cost-effective services rendered to plan participates and result in financially competitive plan rates.
September 23, 2021
Provides technical assistance, consultation, and recommend action plan to SSM Health and PHO's concerning managed care contract review, strategy development, and other managed care matters as appropriate recommendation for execution.
October 07, 2021
Performs other duties as assigned to meet the ongoing needs of the department.
October 15, 2021
Attends related events with marketing to strengthen relationships with PCPs.
November 09, 2021
Participates in Network Management Meetings and makes market recommendations based on in-depth research and details surrounding market requests through analysis of claims, adequacy, and market competition.
November 17, 2021