David Lavine

Experience

1. Program Manager, Provider Performance Management

   Elevance Health (Formerly Anthem)

   Sep 2022 — Present · San Diego, CA, US

   Program Manager for Anthem CA MedicaidProvider Performance Management team• Managing provider group performance through education, contracting efforts, and corrective action plans • Managing projects for Network Adequacy and Timely Access to Care• Manages reporting to multiple state regulators (DMHC, DHCS, NCQA)• Developing program strategy, and partnering with providers to fill provider workforce gaps as Network Adequacy Lead• Presenting on Network Adequacy at director-level internal and external committees and workgroups. • Subject Matter Expert for Quest QES Network Adequacy Software• Developed the Timely Access Dashboard in Tableau utilizing three data-streams to create and Timely Access Risk Index. • Managing provider/ external-facing programs, governance, and surveys – collaborating with providers and delegated provider groups • Leading enforcement and escalation of the Network Adequacy program• Administering Timely Access Surveys to monitor appointment availability to ensure compliance with timely access standards• Managed projects to improve timely access survey scores by 9.5%• Serving as Lead on Subcontractor Network Certification – Compliance reporting and network workforce development • Spearheading Network Building Subcommittee – targeted compliance-oriented network gaps with the Fee-For-Service contracting department• Voting Member of the Quality Management Committee

Education

• Stuart High School

  High School Diploma, International Baccalaureate Program

  1995 — 1999

• Syracuse University

  Bachelor of Arts (B.A.) - Cum Laude, Dual Major in Economics (Arts and Sciences); Television, Radio and Film (Newhouse School of Commun.)

  1999 — 2003

• Western Governors University

  Master of Business Administration - MBA, Healthcare Management

  2018 — 2019