While payers recognize the importance of provider network management (PNM), they often struggle with capability gaps; manual, non-standardized processes; disconnected teams; and obsolete, siloed systems. These challenges drive up administrative costs, delay enrollments, lengthens claims processing, and decrease data accuracy.
To enhance the PNM process, payers need to shift from siloed operations to an integrated provider lifecycle approach. Health plans that prioritize PNM as a function and adopt a long-term provider data management strategy will enable network growth, improved member satisfaction and access to care, stronger provider relationships and satisfaction, and data analysis needed to facilitate alternative payment models.
Bethany Richmond is a Director at Chartis and a member of the firm’s Payer Advisory Services practice with 20 years of experience in the healthcare industry. She has extensive advisory experience, serving healthcare clients across the provider-payer spectrum.
Adam Solove is a Principal with Chartis with 30 years of advisory experience. He is regarded for his leadership of teams in the implementation of new products and development of product roadmaps.
Alexis Comrack is a seasoned product management executive and a Principal with Chartis with experience leading teams at the intersection of business and technology focusing on administrative simplification. She has spent the past 9 years in the healthcare industry and an additional 15 years in the higher education space.
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