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URAC
NCQA

Provider Network Development

Community Care’s provider network goals include assisting providers to meet our mission of improving the health and well-being of the community through the delivery of effective and accessible behavioral health services. In addition to creating a sound and consistent credentialing process, we promote a network development process that:

  • Identifies and builds upon the strengths of our provider community.
  • Develops additional capacity to meet the unmet needs of members, families, and the community.
  • Actively recruits among providers who offer programs that meet the needs of priority populations.
  • Works within our network to clarify capacity needs and assess timeliness of access.

Our Quality Management and Outcomes staff, Quality Committees, management team and operations teams regularly discuss and review key quality indicators. These include, but are not limited to:

  • Access and Availability
  • Continuity and coordination of care across delivery settings
  • Quality, costs and outcomes of health services
  • Use of Preventive services and health education
  • Accuracy and appropriateness of authorizations
  • Compliance with Act 68
  • Service utilization by priority populations

Network Resources
Site Visit Tools Guidelines and forms to help you prepare for Network Management site visits that you may participate in as a network provider.
Provider Representatives Names and contact information for Community Care representatives and details on how they are assigned to each facility and practitioner.