The payer extract must reflect real clinician availability without reshaping care routing on incomplete evidence.
A fast correction protects the filing deadline, while a cautious review protects members and providers from wrong sub-network assignments.
Who you’d be doing this for
“My compliance lead is asking why members are getting names that providers say are no longer available.”
Ai Gao · Behavioral Health Network Executive
Leads network adequacy reporting for a health plan using the clinician network and payer-facing performance data.
What is at stake
Recently changed clinician availability is landing some members in the wrong sub-network. You must weigh a one-time data replay against the risk of certifying access that members cannot use.
Why it isn’t already fixed
Every obvious fix costs something else. That’s the part you’d have to decide.
- filing deadline vs clinician-level correctness
- aggregate confidence vs member-level routing safety
- production replay speed vs irreversible data changes
- complete network evidence vs bounded exceptions
Why Headway
Payer-facing sub-network logic determines whether reported behavioral health access corresponds to clinicians members can actually reach.
Written with these in mind
Not your kind of problem? 75 more at Headway, or browse every organization.
This is the setup. The work is inside.
Running it puts you in the room: the full situation and its constraints, stakeholders who push back in their own words, and the decisions that are yours to make. What you produce becomes a Day One Plan — work you can show someone instead of describing.