Glenridge Health

Hospitals and Health CareMaryland, United States51-200 Employees

Provider networks are critical to the success of every Health Plan. That’s why they must dedicate so many resources to building networks, and then continually monitoring them to ensure they remain compliant. Once provider networks are launched in the marketplace, Health Plans must analyze performance to ensure that each network is marketable, competitive, aligned and cost-effective – in other words, optimized.

And just as one plan year ends, another begins, and the process starts again. Glenridge Health calls this the Provider Network Life-cycle…and it is a never-ending cycle that can drain Health Plans'​ resources.

Glenridge Health is the leading resource for health plans that are struggling to build, maintain or optimize their provider networks. Because we are agile and can pivot as needed, Glenridge Health can assist at any point during the Provider Network Lifecycle. We can conduct the initial network analysis, manage provider recruitment and contracting, evaluate reimbursement rates, test for Adequacy, manage regulatory filings and prepare and submit HSD tables on our clients’ behalf. Health Plans who use our services operate more efficiently, serve their members more effectively and are more competitive in the marketplace. 

Our solutions control costs, improve outcomes and ensure compliance for national, regional and local Health Plans. Glenridge prepares clients for risk-readiness by creating and executing value-based contracting programs that enable clients to remain competitive in the marketplace. We have established provider networks for all product types including traditional commercial programs, exchanges (public & private), direct-to-employer/ TPA, ACO (MSSP & other), Medicare, Medicare Advantage (EGWP and Individual), specialty Medicare Advantage programs, Medicaid and specialty Medicaid programs.

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