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PBH Local Business Plan 2007 <br />Director of Network etwork Coordinator Area Coordinator for Development <br />Maeayement Data Analysis and Provider'RalaNons Taam <br /> Declsibn Support (mamhers ropart to the <br /> Director Network'. <br /> Thl team H responsible for This team Is responsible for Maney®ment) <br /> toll ng and malntalning support and customer service <br /> Ihf <br />P inedon about the PBH. <br />Ider Network that H, used to for IndNidual providers In the <br />.PBH Network The unit <br />The Development Team Wnslsfs of <br /> pro Ide management and : enrolls provldeB, develops subJect matter experts responsiblaifar <br /> mo Itoring Information, This unit contrails, and monitors bringing on Ilne and supporting new <br /> is ponslblefor written compliance wltit'the business service modals acid practices. Team will <br /> dais such as contract requirements oP contracts. collaborate wfth Prmker Reladon5' <br /> for ats, and the provider The unit Is responslblefoe Managers and other departrnents in <br /> ma$ ual. The unit develops ceilatiwatNe actvites with planning'implementation of services, <br /> rep~ iis and monlWrs and among providers In prder <br /> p rmance data, and ensures to achieve the goals of the Initial team: <br /> the Departrnent staff have Network Development Plan... Substance Abuse <br /> <br />', ap priatelnformatlon. Megtal Health (primary consumer)' <br /> m:of Cere <br />Chair Network Operations Team: Manage credentialing process for Coordinate provider training Develop implementation timelines, <br />cross agency monitoring of independent practitioners calendar coordinate activities, assist in solving <br />indicators and problem solving problems, and ensure services come on <br />activities. line accordin to schedule <br />Provider Relations and Customer Provider manual Training orientation of Monitor service implementation; assist in <br />Service: establish partnership with providers: coordinate clinical problem solving, work with Access/UM to <br />providers to ensure healthy training (with QM, UM, I5, facilitate appropriate referrals of <br />network providing quality services. Finance), provide operational consumers. Transition to Provider <br /> training Relations manager when appropriate. <br />Oversight for contract development Development of contract formats Development of Routine <br />and execution; directly Involved in contracts and amendments <br />wntract negotiation for new for additional services; MOA's <br />services and/or providers as <br />indicated. Collaboration with <br />Finance to establish rates (through <br />Financial 0 erations Team <br />Manage/coordinate network Plaq and conduct provider Monitor for wntract <br />communications satisfaction survey compliance Including <br /> maintenance of required <br /> insurance, and special <br /> contract requirements such as <br /> specific substance abuse <br /> requirements that cannot be <br /> tracked through enrollment <br /> and encounter re ortln . <br /> Represent PBH in county and Recruitment: new providers <br /> regiDnal disaster planning to address new service needs <br /> actiylties; coordinate provider and gaps in the network <br /> pardcipatlon as needed <br /> Coordination of NCQA actvities Oversee technical assistance <br /> for Network Operations and customer service <br /> functions of Provider <br /> Relatons Managers. <br /> Provide ongoing support for <br /> providers through identified <br /> Liaisons for each provider <br /> (Personal Banker model); <br /> Liaison facilitates needed <br /> support for individual <br /> providers from QM, IS, <br /> Finance, etc. Single point of <br /> contact for Providers. <br /> Enroll /endorse providers Into <br /> network <br />G . ~"~ 2B <br />