Charles G.

About Charles G.

Healthcare leader, experienced in Healthcare Operations; Patient and Provider Relations.I\'m passionate about the business of healthcare and how it impacts our community and my role in it!

Experience

1. Network Engagement Manager - Desert Region

   Select Health

   Jun 2024 — Present

   Lead and develop teams of Provider Engagement and Provider Relations.• Monitor provider performance metrics; implement improvement and corrective action plans.• Enforce contract terms and regulatory compliance in collaboration with Contracting/Compliance.• Resolve escalated provider issues, grievances, and claims/configuration challenges.• Build and maintain reporting frameworks to track strategic and network performance initiatives.• Manage vendor tool rollouts, including CRM system implementation.• Represent provider relations across quality, financial performance, population health, HEDIS/Stars, and accreditation.• Partner with leadership to drive network growth, retention strategies, and outreach outcomes.• Oversee audits, surveys, credentialing, contracting, and practice transformation projects.• Define and execute quarterly/annual strategic goals for provider relations and engagement.• Collaborate with Marketing on provider outreach strategies and collateral.• Align outreach strategies with data-driven evaluation, communicating outcomes across teams.• Partner with Sales, Stars, and Risk Adjustment to support product performance.• Serve as Provider Relations Lead and primary contact for claims reviews, member issues, and provider support.• Recruit, onboard, and train staff; design training modules to strengthen skills and culture.• Direct cross-functional committee projects to streamline operations and optimize workflows.• Conduct claims/configuration audits to identify systemic issues and enhance efficiency.• Lead provider recruitment, contracting, and network expansion (345+ PCPs for ACA commercial members).• Drive process improvements to align contracting strategies with organizational scalability.• Key contributor to Medicare Risk transition to Intermountain Health Nevada.• Foster strong provider engagement and interdepartmental collaboration to boost performance.

Education

• Colorado State University Global

  Master's degree, Healthcare Administration / Human Resources

  2016 — 2018

• Southern New Hampshire University

  Bachelor's degree, Health/Health Care Administration/Management

  2013 — 2015

• Colorado State University Global

  Master of Science - MS, Health/Health Care Administration/Management

• Southern New Hampshire University

  Bachelor of Science - BS, Health/Health Care Administration/Management