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 Web Learning Series
Tips & Tricks in the Quest Analytics Suite Do you want to learn more about reporting in the Quest Analytics Suite? Whether you are a new user, a seasoned pro...
Join Quest Analytics at Becker’s Spring Payer Issues Roundtable
We’re thrilled to see you at Becker’s Spring Payer Issues Roundtable on April 8-9, 2024. As a trusted leader in healthcare provider network management, we are excited to sponsor and...
AHIP Conference
We’re excited to be back at AHIP 2024, June 11-13, in Las Vegas, Nevada! We have some exciting new features and functionalities in Quest Enterprise ServicesTM that will help you...
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,...

Case Studies

“Are We Compliant — or Not?”
They had no effective way to find their own adequacy gaps — but CMS and state regulators were finding plenty
Working Smarter, Not Harder
The Sales team at a Top 10 National Payer needed to stand out from their competitors when responding to Employer Group Benefits RFPs. To do so, quickly generating network access...
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.
Oversight, Meet Insight
They had manual oversight of provider network adequacy—but zero insight into provider availability, provider data accuracy or performance across health plans.
Uniting an Enterprise
Struggling to meet the diverse adequacy requirements of CMS and states, the plan needed a smarter way to work.
More Than Meets the ROI
A costly CMS penalty proved they couldn’t keep managing their provider networks the same old way. For a New York health plan, smarter provider network management was a better investment...

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.

Schedule Now