Providing members with access to a robust network of providers while simultaneously decreasing costs and improving outcomes is the goal of an effective managed care organization. To meet this goal, a well-developed provider program is essential. Clearlink combines our experience with a client specific customized approach to ensure your health plan moves to the forefront of the market competition.
Whether you are looking to build a new provider network, enhance an existing network, optimize your contracting operations, or develop new strategies, Clearlink Partners has the experts and tools to ensure optimal execution.
Clearlink Partners collaborates with managed care organizations to establish the foundational capabilities on which provider relationships can develop into true partnerships. By maximizing the value of these relations, implementing innovative contracting strategies, and maintaining provider data accuracy, healthcare organizations will achieve cost savings, process efficiencies, and increased provider and member satisfaction.
Optimize how the Provider Relations and Contracting functions fit into your overall organizational structure – defining and enhancing roles, responsibilities and work processes that support provider network development and performance for both internal and external customers.
Develop short- and long-term strategies to support business plans for improving your existing provider relationships and build competitive entry strategies for new products and markets that establish the “fastest path to adequacy” with the goal of building a highquality network, front of mind.
Evaluate and make recommendations on contracting strategy, contract template development, best practices, value-based reimbursement strategies, and establish the processes and systems needed to manage the work and accelerate performance.
Improve provider recruitment, retention, and partnership plans to support the specific markets and populations served, considering optimal access and accessibility. Take it one step further and leverage our experienced network development staff to recruit, build and negotiate for networks and gaps across all provider types.
Support daily network operations, build business development plans, and enhance tools and reports to measure what matters. Leverage data to inform decisions on when to add providers, sever relationships, negotiate and/or compromise to improve the plan’s financial performance and your market position.
Update, monitor and manage provider data elements that have grown in their complexity and volume. Our experienced consultants can help you evaluate your plan’s work process and data management systems to extrapolate how that data flows to operations, systems, vendors and customers.
Assess existing programs to identify gaps and opportunities to build new programs, provide guidance on strategy to monitor effectiveness, and build partnerships that leverage your network to differentiate access, engagement, service and performance.
Our thorough Opportunity Assessment is an evaluation of your provider network & contracting operations. Leading experts from Clearlink will review your existing provider programs, including audit concepts, tools, software, vendor performance, organizational design, and more.
The output of the assessment is a list of targeted opportunities and estimated savings, assuring you have value and confidence in your selection of Clearlink Partners to optimize your provider contracting and network strategies.