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Great Plains Health Innovation Network

Finance and payer committee

Committee members

  • Dr. Todd Hlavaty
    Dr. Todd Hlavaty
    Chair
  • Dr. Leland Lamberty
    Dr. Leland Lamberty
    Vice-Chair, Board Representative
  • Dr. Dustin Christensen
    Dr. Dustin Christensen
  • Dr. Millie Erickson
    Dr. Millie Erickson
  • Dr. David Hatch
    Dr. David Hatch
  • Dr. Narayana Koduri
    Dr. Narayana Koduri
  • Tom Legel
    Tom Legel
    GPH CFO

Membership and credentialing committee

Committee members

  • Dr. Clark Diffendaffer
    Dr. Clark Diffendaffer
    Chair
  • Shawn Murdock
    Dr. Shawn Murdock
    Vice-Chair
  • Dr. Kent Allison
    Dr. Kent Allison
  • Dr. Kristen Burwick
    Dr. Kristen Burwick
    Board Representative
  • Dr. Benjamin Klug
    Dr. Benjamin Klug
  • Dr. Kristin Lake
    Dr. Kristin Lake
  • Dr. Rich Raska
    Dr. Rich Raska
  • Dr. James Smith
    Dr. James Smith
  • Darrel Smith
    Darrel Smith
    GPH Board Representative

Membership & Credentialing Committee Charter

Purpose

The purpose of the Membership/Credentialing Committee is to provide leadership to, and oversight of, the recruitment, onboarding, and retention/removal of physician members and other categories of provider members (e.g., advanced practice nurses and allied health professionals included in the network) through the development of policy and procedure recommendations (for Board of Directors' ["the Board'] approval), as well as administration of credentialing/re-credentialing and membership responsibilities, as delegated to it by the Board.

Responsibilities

The Committee will develop policy and procedure recommendations, for Board approval, related to the processes and procedures for recruitment, onboarding, and retention/removal of physician members. In addition, as delegated to it by the Board, the Membership/Credentialing Committee will oversee membership approval/removal pursuant to Board approved policies and procedures. Principle responsibilities are as follows:

  • Develop and recommend policies and procedures for Board approval related to network membership criteria, including physicians and, as appropriate, advanced practice nurses, and allied health professionals
    • Included in these policies and procedures will be consideration of relevant credentialing and re-credentialing processes with hospital medical staff and managed care organizations
  • Coordinate with the Finance/Payer Committee to help obtain and maintain delegated credentialing status with payer organizations (including, as applicable, obtaining and maintaining ongoing National Committee for Quality Assurance credentialing certification), as directed by the Board
  • Develop, recommend, and obtain Board approval for policies related to conflict of interest for "rank-and-file" physician and any other network members
  • Coordinate with the Clinical Quality/HIT Committee in the development of proposed minimum program performance levels or standards for physician members, for Board approval
    • Integrate minimum performance standards into membership application/credentialing and re-credentialing processes
  • Develop, recommend, and obtain Board approval for processes for managing physician membership applications and credentialing and membership approval, in coordination with hospital and payer credentialing processes
  • Administer the membership/credentialing application and re-credentialing process pursuant to Board-approved policies and procedures (above) and provide to the Board with regular reports related to membership application approvals/denials
  • Coordinate with the Clinical Quality/HIT Committee and management to develop and oversee the administration of new member orientation, mentoring, and other onboarding processes
  • Coordinate with the Clinical Quality/HIT Committee and management to develop and administer processes for identifying under-performing physicians, intervention and progressive remediation programs, and eventual removal of intransigent or chronically under- performing physicians and any other network members
  • Develop and administer appropriate processes for appeals of membership/credentialing and re-credentialing decisions
  • Review and oversee disposition of patient and physician complaints

Quality and IT committee

Committee members

  • Dr. Wendy Gosnell
    Dr. Wendy Gosnell
    Chair, Board Representative
  • Dr. Ladd Lake
    Dr. Ladd Lake
    Vice-Chair
  • Dr. Byron Barksdale
    Dr. Byron Barksdale
  • Dr. Jeff Brittan
    Dr. Jeff Brittan
  • Dr. Raymond Carlson
    Dr. Raymond Carlson
  • Dr. John Eitzen
    Dr. John Eitzen
  • Dr. Renee Engler
    Dr. Renee Engler
  • Dr. Eduardo Freitas
    Dr. Eduardo Freitas
  • Emily Jones
    Dr. Emily Jones
  • Brandon Kelliher
    Brandon Kelliher
    GPH CIO
  • Dr. David Lindley
    Dr. David Lindley
  • Dr. Kathy Lopez
    Dr. Kathy Lopez
  • Mel McNea
    Mel McNea
    GPH CEO
  • Dr. John Milhailidis
    Dr. John Milhailidis
  • Barb Petersen
    Barb Petersen
    GPH Chief Quality Officer
  • Dr. Jovanka Vuksanovic
    Dr. Jovanka Vuksanovic
  • Dr. Jacob Weisen
    Dr. Jacob Weisen
  • Dr. Joshua Wray
    Dr. Joshua Wray

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