Elyse Latella

Elyse Latella

Network Optimization Lead @Clover Health

New York, NY, US
EMAILS
e••••••••@cloverhealth.com
MOBILE NUMBERS
+19•••••••91

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WORK HISTORY

Feb 2022 — Present

Network Optimization Lead @Clover Health

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Oversee network adequacy across all counties where Clover operates and manage any identified gaps in coverage.• Use of Adequacy software to support network adequacy and network expansion as per CMS guidelines/ regulations.• Manage provider roster data in support of network adequacy responsibilities.• Providing regular reporting in support of all network expansion activities• Supporting development of HSD Tables for annual CMS MA Bid process• Support Network Development.• Develop and refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting, and other value-based initiatives.• Address and resolve any concerns or challenges raised by providers and effectively communicate them.• Engage and partner with marketing, legal, finance, and other internal teams to support contracting and development opportunities

EDUCATION

2003 — 2006

Stockton University

BA, Psychology

2010 — 2014

Centenary University

Master's, Counseling

SKILLS

PowerpointMicrosoft ExcelEmrConflict ResolutionCase ManagementMedicarePediatricsHipaaNetwork Management ApplicationsManagementTeam BuildingHealth InsuranceManaged CareHealthcareMicrosoft OfficeMental HealthOrganizational DevelopmentHome CareInsuranceCustomer ServiceData EntryHealthcare Information TechnologyLong-Term CareProvider RelationsStrategic PlanningTrainingNursingHealthcare IndustryHospitalsHealthcare ManagementMedicaid

ABOUT ELYSE LATELLA

I am a strategic Network Engagement and Provider Relations leader dedicated to building high-performing, compliant healthcare networks. With a deep focus on Network Adequacy and Provider Contracting, I bridge the gap between complex managed care requirements and meaningful provider partnerships.My approach combines data-driven negotiation with a \"provider-first\" mindset, ensuring that network operations aren\'t just seamless, but sustainable. I thrive at the intersection of conflict resolution and community relations, turning challenging negotiations into long-term, value-based collaborations

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