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Health Network Operations

Health Network Operations. Consists of Network Development Network Management. Health Network Operations. Nine Counties. Population: 1 million. Responsible for development and management of Sandhills Center’s Provider Network based on population and geographic area. Assesses

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Health Network Operations

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  1. Health Network Operations Consists of Network Development Network Management

  2. Health Network Operations Nine Counties Population: 1 million Responsible for development and management of Sandhills Center’s Provider Network based on population and geographic area.

  3. Assesses Provider Capacity Access Availability Tools for Assessment Geo-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

  4. 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

  5. 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.

  6. Quarterly Provider Forums Network Leadership Council (NLC) Health Network Operations

  7. Health Network Operations • Provider Help Desk 1-855-777-4652

  8. 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

  9. 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.

  10. Questions?

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