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Great Plains Health Innovation Network

Finance and payer committee

Committee members


  • Dr. Todd Hlavaty
    Chair

  • Dr. Leland Lamberty
    Vice-Chair, Board Representative

  • Dr. Dustin Christensen

  • Dr. Millie Erickson

  • Dr. David Hatch

  • Dr. Narayana Koduri

  • Tom Legel
    GPH CFO

Membership and credentialing committee

Committee members


  • Dr. Clark Diffendaffer
    Chair

  • Dr. Shawn Murdock
    Vice-Chair

  • Dr. Kent Allison

  • Dr. Kristen Burwick
    Board Representative

  • Dr. Benjamin Klug

  • Dr. Kristin Lake

  • Dr. Rich Raska

  • Dr. James 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
    Chair, Board Representative

  • Dr. Ladd Lake
    Vice-Chair

  • Dr. Byron Barksdale

  • Dr. Jeff Brittan

  • Dr. Raymond Carlson

  • Dr. John Eitzen

  • Dr. Renee Engler

  • Dr. Eduardo Freitas

  • Dr. Emily Jones

  • Brandon Kelliher
    GPH CIO

  • Dr. David Lindley

  • Dr. Kathy Lopez

  • Mel McNea
    GPH CEO

  • Dr. John Milhailidis

  • Barb Petersen
    GPH Chief Quality Officer

  • Dr. Jovanka Vuksanovic

  • Dr. Jacob Weisen

  • Dr. Joshua Wray

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