Consists of Network Development Network Management Health Network Operations.
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Consists of Network Development Network Management Health Network Operations
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Transcript of Consists of Network Development Network Management Health Network Operations.
Consists of
Network Development Network Management
Health Network Operations
Health Network Operations
• Responsible for development and management of Sandhills Center’s Provider Network based on population and geographic area.
Nine Counties Population:
1 million
Health Network Operations
Assesses – Provider Capacity
– Access
– Availability
Tools for AssessmentGeo-Access mapping of service
providers in the geographic area.
Use of Data Generated by State Parameters of timeliness- emergent, urgent and routine services; travel times/distances to access services
Use of State-generated data regarding wait times for services; needs assessments and surveys
Health Network Operations
Makes available to provider network members access to all pertinent rules and regulations necessary for provider performance outlined in Contract.
Provider Manual Sandhills Website
Health Network Operations
Provides and assists network providers with evidence based training opportunities.
Routine communication with providers to share information and resources, provide technical assistance; resolve informal complaints
Responds to questions and directs providers to other resources.
Health Network Operations
Quarterly Provider Forums
Network Leadership Council
(NLC)
Health Network Operations
Provider Help Desk
1-855-777-4652
Health Network Operations
Credentialing Activities for Provider Network
Sandhills Center Health Network Operations is now responsible for credentialing of providers requesting inclusion in Sandhills network
Use of Quality of Care indicators, such as national accreditation, DMA good standing, to insure providers meet state local requirements.
In addition, monitoring of provider performance with required regulations such as licensure and accreditation / reaccreditation
Health Network Operations Maintains information
on network providers for purposes of: Assisting with choice of
provider Analyzing service array,
capacity and accessibility Providing provider
information to other Sandhills Departments as needed. Management / oversight of network provider disputes/ appeals.
Questions?
