Oversee monitoring of quality, utilization and overall clinical performance to enable CHC to demonstrate quality and effectiveness. Identify population health priorities that lead significant change and improvement in quality, cost and overall value of health care.

Assure member compliance with supplemental data reporting / submission. Oversee adoption of clinical guidelines, health maintenance reporting and integration of CHC’s care management and population health initiatives across the network through primary care and specialty practice redesign and improvement. Oversee CHC CME education program.

Increase network member participation. Review practice pattern variations and out of network utilization. Hold members accountable for performance with network standards. Provide education and mentorship as needed. In collaboration with the CHC medical Director, provide physician credentialing and peer review interventions or oversight. Establish and oversee processes for member compliance of ACO and CIN.

Identification and prioritization of clinical guidelines for the network. Approval of guidelines and the analysis of clinical data including adoption / use of approved clinical guidelines. Provide physician credentialing and peer review referral as indicated to the Credentialing Committee and the CIN medical director.