Denise Croce Named Executive Vice President of Clinical and Provider Management for Health Partners Plans

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Veteran health care leader Denise Croce has returned to Health Partners Plans as executive vice president of clinical and provider management, reporting to President and Chief Executive Officer William S. George. In this new role, Croce will focus on care management and utilization across all lines of business, including Medicare (Health Partners Medicare), Medicaid (Health Partners) and CHIP (KidzPartners). In addition, Croce will be responsible for the strategic development of all provider network relationships and maintaining Health Partners Plans' high provider satisfaction ratings while improving contracting processes (see also Health Partners Plans).

During her more than 20 years of experience in hospital operations and managed care, Croce has implemented transformative clinical and provider strategies that increase membership and member satisfaction while optimizing utilization management.

Croce served as senior vice president of healthcare management operations at Health Partners Plans from 2004 to 2006. In that role she oversaw utilization, case and disease management, accreditation and a variety of other clinical quality functions. Since then, she has held several executive level positions at Coventry, AmeriGroup and AETNA Medicaid.

"Denise has a proven track record improving the performance of several leading health care companies through implementing transformative clinical and provider management processes, more streamlined business practices and exceptional member care," said William S. George. "I look forward to her leadership as we take our best-in-class care management and services to new markets."

"It's an honor to return to such a high-performing leader in health care - one that is top-rated among members and providers," said Croce. "I look forward to leveraging my experience in the managed care sector to build on Health Partners Plans' strong track record of improving access to quality health care during this exciting time of growth."

Croce received her Bachelor of Science in Nursing from Widener University and her Master of Health Administration from St. Joseph's University. She's also a registered nurse in Pennsylvania and New Jersey. About Health Partners Plans Nationally recognized for its innovations in managed care, Health Partners Plans consistently receives high ratings for member and provider satisfaction and is one of the highest rated Medicaid plans in Pennsylvania according to the National Committee for Quality Assurance's (NCQA) Medicaid Health Insurance Plan Ratings 2015-2016. Health Partners Plans is a not-for-profit managed health care organization serving more than 256,000 members in the Greater Philadelphia region. It provides a broad range of health coverage options through Health Partners Medicare, Health Partners (Medicaid) and its KidzPartners (Children's Health Insurance Program) plan. Founded more than 30 years ago, Health Partners Plans is one of the few hospital-owned health plans in the country. Learn more about how Health Partners Plans is "doing it right" at HealthPartnersPlans.com, twitter.com/HPPlans and facebook.com/healthpartnersplans. View source version on businesswire.com: http://www.businesswire.com/news/home/20160302006522/en/

Keywords for this news article include: Hospital, Medicaid, Medicare, Legal Issues, Managed Care, Health Policy, Health Insurance, Health Partners Plans.

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