Vice President of National Payers

HI, I’M JAMES LAMB

I’m here to help you gain a comprehensive view of your provider data, enabling you to make strategic decisions about your network and achieve the best possible care for your members. 

BREAKING SILOS, LEVERAGE EFFICIENCIES AND REDUCING RISK

Seeking scalability and visibility across all of their networks, a new SVPs started putting a plan in motion that has led to greater compliance confidence, consistent reporting and faster speed to market. Learn what it takes to break down organizational silos and what you can expect to gain as the reward.

A PROVEN EXPERT

James is a distinguished expert in provider network management with a track record of leadership and success. With nearly a decade of experience as a strategic partner for prominent healthcare organizations, including the nation’s eight largest, he has played a pivotal role in enhancing network performance, ensuring regulatory compliance and advancing access to care across all lines of business. Committed to promoting equal access to healthcare, James devotes his time to serving on multiple Boards for non-profit organizations dedicated to improving the lives of individuals with special needs.

Four Things to Know: CMS MA Final Rule

The Four Phases of Implementing a Provider Data and Directory Verification Process

Provider Data Errors to Avoid When Responding to a Medicaid RFP

MHPA 2022 maybe over but the planning never stops. Let’s stay connect and continue the conversation about achieving your goals.

Upcoming Events

Quest Analytics Regulator Exclusive Webinar
Join us for a regulator-exclusive webinar as we dive into the complexities of provider directories, claims analysis, ghost providers and the pursuit of data accuracy in healthcare networks. 
Discussion with CCIIO: Role of Network Adequacy in Consumer Protection
Quest Analytics® is hosting leadership from The CMS Center for Consumer Information and Insurance Oversight (CCIIO) for a conversation about how network adequacy requirements and standards support their mission of...
Vision Quest
Elevating Provider Network Management through Innovation and Industry Collaboration Join us on September 10-12, 2024, in Austin, Texas Vision Quest offers an exclusive opportunity to connect with thought leaders, influencers,...
NADP Converge Conference
We’re excited to be back at NADP 2024, September 23-26, in Minneapolis, Minnesota! We have some exciting new features and functionalities in Quest Enterprise ServicesTM that will help you comply with...
Consumer Experience And Digital Health Forum
We’re excited to be back at the 2024 Consumer Experience and Digital Health Forum, September 24-26, in Nashville, TN! We have some exciting new features and functionalities in Quest Enterprise...
CAHP Annual Conference
We are excited to see you in person at the CAHP Annual Conference in Desert Springs, CA from October 21-23, 2024! We have some exciting new features and functionalities in...

Case Studies

A Tale of Two Networks
Having struggled to build a Medicaid network, they now faced the more complex requirements of Medicare — with only one shot to get it right.
“Are We Compliant — or Not?”
They had no effective way to find their own adequacy gaps — but CMS and state regulators were finding plenty
The Best Offense Wins
Their team was looking for automated and integrated tools and insights that would allow them to better communicate the value of their Integrated Delivery Network, by specialty, with an end...
Too Bad to Ignore, Too Big to Fix
Provider data accuracy issues could have jeopardized their partner relationships — but they didn’t have an effective way to address them.
Building Their Own HMO
Wanting to set up their own HMO, they needed to build a county-wide Medicare Advantage network — with no previous experience managing CMS network adequacy requirements
Uniting an Enterprise
Struggling to meet the diverse adequacy requirements of CMS and states, the plan needed a smarter way to work.

SOLVE YOUR PROVIDER DIRECTORY ACCURACY CHALLENGES TODAY

Our team is ready to help you address the challenges provider data presents. We want to help you take your member experiences to the next level and avoid regulatory risks, like audits, and meet the mandates around surprise billing.

Contact us today to book a strategy session to understand and provide guidance to limit your exposure.

Start a Conversation Today!