Provider Network Development and Contracting

Glenridge has been providing network development support to healthplan clients for 10 years. We have built our company - including professional staff, communications and data management technologies, and a call center/document processing center - to help managed care organizations and healthplans build and/or expand provider networks on a small or large scale. We have a proven track record of success working with regional and national insurers, providing a virtual work force to industrialize network development initiatives while seamlessly integrating into clients’ existing systems and operations.

Glenridge is called on to provide a range of services, and may be considered a turnkey team to whom you can outsource a network development or network contracting initiative, or a limited-scope resource to supplement your internal contracting and/or analytical assets. Our managed care professionals and technologies enable our clients to:

• achieve contracting goals
• establish positive provider relations
• manage project data and resources
• generate sophisticated real-time management reports, network gap analyses and other project-specific deliverables (e.g., HSD Tables to CMS, provider directories, and state provider listings for Medicaid networks).

We have particular expertise in Medicare and Medicaid programs, and are quite familiar with the unique contracting and reporting requirements of these government managed care programs. We have extensive experience with RFP responses, customized provider network recruiting, provider directory reporting, operational readiness reviews, and other critical requirements for a successful launch of Medicaid and/or Medicare managed care program on an aggressive timetable.