Erik D. Helms
Provider Network Executive Leader | Strategic Partner | Payer and Provider Experience | Value-Based Contracting Innovation | Proven Quality Improvement and Margin Growth | Government Programs Expertise
- Role
- Senior Vice President, Provider Network Contracting and Performance Improvement at Commonwealth Care Alliance
- Location
- Columbus, OH, US
- LinkedIn followers
- 500 followers
About Erik D. Helms
As a dynamic healthcare executive with proven leadership in driving transformative…
Experience
Senior Vice President, Provider Network Contracting and Performance Improvement
Jan 2024 — Present · Boston, MA, US
Executive leader at Commonwealth Care Alliance® (CCA), a mission-driven healthcare services organization that offers health plans and care delivery programs designed for individuals with the most significant healthcare needs. CCA provides services to more than dually eligible individuals. • Lead responsibility for integrating and aligning provider network strategy, managed care contracting, and operations with Commonwealth Care Alliance’s (CCA) strategic objectives, including national provider network contracting strategies and standards, value-based contracting strategy, design and execution, contract management and operations processes, payment integrity best practices, and provider credentialing / provider data management. • In partnership with key network health systems and Behavioral Health, LTC, and LTSS providers, contract, design and implement differentiated value-based reimbursement models that drive a nationally leading provider and member experience, improves STARS performance (CCA is a 4+ STAR health plan) and incremental EBITDA to the health plan and the provider partners. • Executive oversight of $700M value-based integrated primary care, behavioral health and complex care management delegation portfolio with industry leading provider partners that supports and drives coordinated improvements in population outcomes, member experience, and financial performance.• Provide leadership and strategic re-alignment of national, market-based, and off-shore resources across five discrete business units to ensure alignment with profitability, membership growth, provider partnership strategies and operational objectives of Commonwealth Care across an addressable market of over 2M complex care dually eligible lives.
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