Provider Network Management is one of the key challenges faced by health insurance providers in the US health care ecosystem. The interactions between insurance providers and health care providers are multi-dimensional, all the way from claims submissions to contract management to collaborating towards better health care outcomes. A holistic approach is required to resolve all the ensuing, strategic, tactical & operational challenges faced while managing this complex relationship. We intend to elaborate more on the nuance to the relationship & how digital technology can help solve the key problems and bring structure to the multi-faceted management paradigm required to solve the same.
Provider network management encompasses a wide variety of components, from preventing referral leakage to managing the price for a given clinical procedure. Healthcare provider network management helps the payers access accurate provider data, verify it, and update it as needed.
This webinar will focus mainly on the importance of payer provider collaboration to achieve enhanced care delivery to members and reduce overall costs. It talks about the rising cost burden on health plans due to data fragmentation and how it is affecting healthcare. Learn how payers can overcome inefficiencies across functions and generate more savings and better patient outcomes.
David Nace, MD
Chief Medical Officer
Dr. David Nace is the Chief Medical Officer at Innovaccer Inc and is the past Board Chair of the PCPCC. Previously, Dr. Nace served as Vice President, Clinical Development for McKesson Corporation, Senior Vice President and Chief National Medical Officer with Aetna, and subsequently with United Health Group.
He is also currently a Board Member for the Integrated Healthcare Association, a statewide multi-stakeholder leadership group that promotes quality improvement, accountability and affordability of healthcare in California; and the Care Continuum Alliance, based in Washington, DC. Dr. Nace earned his medical degree from the University of Pittsburgh.
Fran Soistman Jr.
Executive Healthcare Advisor
Healthcare Management and Transformation Advisory Services LLC
Fran Soistman is the Founder and President of Healthcare Management and Transformation Advisory Services LLC (HMTAS). Prior to this he was Executive Vice President at CVS Health-Aetna , where he led their Government Services Business portfolio, the growth engine of the company.
Fran also represented Aetna on the Health Care Transformation Task Force, and served as its Chairman until his retirement from CVS Health-Aetna on October 1, 2019. He was a recipient of the 2004 Ernst & Young Entrepreneur of the Year award in the Healthcare Technology/Services category.
Health Care Transformation Task Force
Jeff Micklos is the Executive Director of the Health Care Transformation Task Force. An attorney by training, Jeff is the former Executive Vice President, Management, Compliance, & General Counsel of the Federation of American Hospitals, a national trade association representing investor-owned hospitals, and a former Partner in the Health Law Department of the international law firm of Foley & Lardner LLP.
Jeff began his career as a litigator and regulatory counsel for the Health Care Financing Administration, U.S. Department of Health and Human Services, and also served in the Office of General Counsel of the Social Security Administration. Jeff is a graduate of the Columbus School of Law, The Catholic University of America, and received a Bachelor Arts Degree from Villanova University.