Regional Health Plan Builds
Recent Works
Please reference the portfolio content to learn more about projects associated with Regional Health Plan builds.
Medicaid RFP Build
- Building the client a marketable Medicaid provider network in response to a state RFP in the Southeastern region. This will be inclusive of 20 initial core counties for a new-market Medicaid entrance.
- Our team will provide a fileable network by Q3 of 2023 and a sellable network by Q3 of 2024 for the Health Plan’s 2025 membership.
- Network development inclusive of hospitals, individual and large professional organizations, behavioral health facilities and ancillary service providers.
New Market Entrance – Southeast
- Built the client a fileable and sellable commercial exchange provider network in the Southeastern region. This will be inclusive of 6 initial core counties for a new-market entrance.
- Our team provided a fileable network by Q2 and a sellable network by Q3 for the Health Plan’s upcoming membership.
- Network development inclusive of hospitals, individual and large professional organizations, behavioral health facilities and ancillary service providers.
New Market Entrance – South Central
- Successfully built the client a fileable and sellable commercial exchange provider network in the South-Central region. This was inclusive of 6 initial core counties for a new-market entrance and resulted in an enrollment of over 40,000 covered lives for the first year.
- Provided a fileable network by Q2 and a sellable network by Q3 for the Health Plan’s upcoming membership.
- Network development inclusive of hospitals, individual and large professional organizations, behavioral health facilities and ancillary service providers.
West Coast Health Plan – New Market Entrance to Texas
- Facilitated the introduction and execution of getting the Health Plan client in-network with a major Health System in the Texas Market.
- This laid the groundwork for the plan to sell their commercial product in the Texas market.
Veterans Affairs Network Build – West Coast, Region 4
- Assisted with the U.S. Department of Veterans Affairs Community Care Network (CCN) build for the 13-state, Region 4 territory.
- Helped scale operations to assist VA in ensuring access to health care services in the community through a VISN-by- VISN rollout approach that was implemented together with VA
Health Plan Expansion – Self Insured Employer Focus – West Coast
- Executed network development initiatives for the only state-licensed chiropractic/acupuncture plan in California, covering 220,000 lives throughout the state.
- Facilitated outreach for network enhancements to provide chiropractic and acupuncture benefits to members of Western Health Advantage, a Northern California HMO and California Choice, the state’s largest small group broker.