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SCS Update Jennifer Marze Senior Provider Relations Rep SC Office of Rural Health July 23, 2013 PowerPoint PPT Presentation


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SCS Update Jennifer Marze Senior Provider Relations Rep SC Office of Rural Health July 23, 2013. Actively building expanded network to function as MCO vs MHN Target Date for Transition: 12/1/13 Current # of Members – 150,631* As of April, 2013. Program Approach:

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SCS Update Jennifer Marze Senior Provider Relations Rep SC Office of Rural Health July 23, 2013

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Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • SCS Update

  • Jennifer Marze

  • Senior Provider Relations Rep

  • SC Office of Rural Health

  • July 23, 2013


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • Actively building expanded network to function as MCO vs MHN

  • Target Date for Transition: 12/1/13

  • Current # of Members – 150,631*

    • As of April, 2013


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • Program Approach:

    • Support Primary Care Providers – Keep them in the “driver’s seat”

    • Deliver services to Members in a way that extends/expands Provider’s reach

    • Focus on Quality and Comprehensive Care Management

    • Be good partners to the Providers

    • Invest in Providers/Community events rather than advertising


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • Activities to “Get Ready for Change”

    • Negotiating and Signing Contracts with all types of providers

    • Engaged Several Experienced Network Development Professionals to help with network build

    • Reviewing and updating all Policies & Procedures in preparation for Readiness Review by Carolinas Center for Medical Excellence

    • Revising all plans and documents to ensure compliance with MCO regulations


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • Additional Activities for Readiness:

    • Revising brochures and fliers for Members on program changes

    • Developing notification letters for SCS Members on program changes when conversion to MCO takes place; anticipate these being sent from SCDHHS end of September; this will especially affect Dual Eligibles & Waiver participants who will be returned to Fee-for-Service

    • Redesigned www.sc-solutions.org website

    • Member Provider Services will assist with MHN needs as well as MCO questions/concerns


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

And More Activities for Working through the change in model:

  • Expanding the Committee Structure required for MCO functions, such as P&T, Credentialing, Peer Review, and Program Advisory

  • Educating Call Center Staff and Provider Relations Representatives on changes in program model so all will continue to be able to meet Member and Provider needs


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

  • Aligning Provider Reports and Dashboards with SCS quality initiatives in a way that supports providers and the State’s efforts; specifically, working with RHCs to ensure transfer of quality measures that are meaningful to you and to SCS

  • Continually improve communications on all levels with enrolled RHC Providers


Scs update jennifer marze senior provider relations rep sc office of rural health july 23 2013

For further information:

Jennifer P. Marze

Senior Provider Relations Representative

803-753-1132 (office #)

803-414-4025 (cell #)

[email protected]


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