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Provider Quality

Provider-Quality


To ensure a continued focus on quality, Fidelis Care is dedicated to engaging with providers to ensure our members get the best care possible. Quality is a critical component of the work we do at Fidelis Care. The Provider Relations Department works diligently to support providers in quality improvement initiatives.


Hearthands

If you have any questions, please contact your Quality Improvement Specialist.

Quality Improvement Specialists
NYC Region:

Name Coverage Area Assigned Counties and/or Providers
Brianni Blue Loftlin 

✉ Email Address

Brooklyn County: 11201, 11203, 11205, 11206, 11207, 11212, 11217, 11211, 11213, 11221, 11226, 11220, 11237, 11238, 11239, 11243, 11249 Brooklyn County
 Yen Min Yau

✉ Email Address

ZIP Codes: 11220, 11204, 11214, 11229 Kings County

Providers: CAIPA & Excelsior Empire Health Brooklyn Providers
 Zinaida Khavasova

✉ Email Address

Kings County: 11219, 11223, 11224, 11229, 11235, 11230, 11204, 11209, 11214, 11228, 11232, 11210,11239, 11218 Kings County

Providers: Maimonides, One Brooklyn Health System: (Interfaith, Brookdale and Kingsbrook) 
 Michael Gayle

✉ Email Address

All ZIP Codes in the Bronx except for providers/groups assigned to an IPA (Balance, Bronx United) Bronx County

Providers: Boston Children's Health Physicians (Westchester County), Northwell (All Affiliated TINs) 
 Stanley Laforest

✉ Email Address

ZIP Codes: 10003, 10004, 10005, 10006, 10007, 10009, 10010, 10011, 10012, 10014, 10016, 10017, 10018, 10019, 10020, 10021, 10022, 10023, 10024, 10025, 10026, 10027, 10029, 10030, 10031, 10032, 10033, 10034, 10035, 10036, 10038, 10039, 10040, 10041, 10044, 10047, 10048, 10128 Various Counties
 Adebunmi (Bunmi) Browne

✉ Email Address

Various ZIP Codes Providers: Balance Medical IPA
 Osaruyi Eduwen

✉ Email Address

Queens County ZIP Codes: 11101, 11102, 11103, 11104, 11105, 11106, 11368, 11369, 11370, 11371, 11372, 11373, 11374, 11375, 11377, 11378, 11379, 11385 Queens County
 Rui Kang (Ray) Lin

✉ Email Address

Queens County ZIP Codes: 111354, 11355
Queens County
Providers: CAIPA & Excelsior Empire Health Queens Provider
 Rosemond Guillaume

✉ Email Address

ZIP Codes: 11365, 11366, 11367, 11411, 11412, 11413, 11414, 11415, 11421, 11422, 11430, 11433, 11434, 11435; 11416, 11417, 11419, 11420, 11423, 11426, 11427, 11428, 11429, 11432, 11418, 11436, 11691, 11692, 11693, 11694, 11697
Various Counties

 Taylor Panzarella
✉ Email Address


Rockland and Westchester Counties: 10977, 10952, 10956, 10901, 10954, 10965, 10980, 10970, 10960, 10989, 10927, 10994, 10923, 10920, 10962, 10983, 10913, 10993, 10974, 10984, 10986, 10968, 10964, 10976, 10931, 10911, 10982, 10701, 10801, 10573, 10705, 10583, 10550, 10704, 10562, 10598, 10710, 10558, 10566, 10557, 10708, 10552, 10703, 10567, 10605, 10543, 10591, 10603, 10805, 10549, 10580, 10804, 10538, 10606, 10528, 10514, 10530, 10803, 10604, 10553, 10570, 10536, 10601, 10520, 10707, 10522, 10523, 10595, 10510, 10709 Rockland and Westchester County

 Haneefah Mahdi

✉ Email Address

Richmond County ZIP Codes: 10301, 10302, 10303, 10304, 10305, 10304, 
10305, 10306, 10307, 10308, 10309, 10310, 10311, 10312, 10313, 10314
Richmond County

Providers: Amboy Medical Practice, Bon Secours, NYC  Health & Hospitals, Refuah Health Center
 Leidy Mejia

✉ Email Address

Nassau County ZIP Codes: 11096, 11509, 11510, 11516, 11518, 11520, 11550, 11552, 11553, 11554, 11555, 11557, 11558, 11559, 11563, 11565, 11566, 11570, 11572, 11575, 11580, 11581, 11598, 11709, 11710, 11756, 11758, 11762, 11783, 11793,11001, 11020, 11021, 11023, 11024, 11030, 11040, 11042, 11050, 11501, 11507, 11514, 11530, 11542, 11545, 11548, 11560, 11568, 11576, 11577, 11579, 11590, 11596, 11714, 11732, 11735, 11753, 11771, 11791, 11797, 11801 Nassau County
 Robert Dean

✉ Email Address

Suffolk County ZIP Codes: 11720, 11721,  11724, 11725,11729;11731, 11733, 11738, 11740, 11741, 11742, 11743, 11746, 11747, 11754, 11757, 11763, 11764, 11766, 11768, 11769, 11776, 11777, 11778, 11780, 11782, 11784, 11786, 11787, 11788, 11790, 11794, 11901, 11930, 11931, 11933, 11934, 11935, 11937, 11939, 11940, 11941, 11942, 11944, 11946, 11948, 11949, 11950, 11951, 11952, 11953, 11954, 11701, 11702, 11703, 11704, 11705, 11706, 11707, 11708, 11709, 11713, 11715, 11716, 11717, 11718, 11722, 11727, 11750, 11751, 11752, 11755, 11767, 11772, 11779, 11789, 11792, 11795, 11796, 11798, 11955, 11957, 11958, 11959, 11961, 11962, 11963, 11964, 11965, 11967, 11968, 11970, 11971, 11975, 11976, 11977, 11978, 11980 Suffolk County
 Kay Stewart-Benjamin

✉ Email Address

Kings County: 11238, 11212, 11234, 11236 Kings County

Providers: NYU and Affiliates,  NYPHS and Affiliates, Mount Sinai and Affiliates
 Nadia Oleniak

✉ Email Address

ZIP Codes: 02886, 06484, 06518, 07020, 10002, 10003, 10006, 10007, 10010, 10013, 10016, 10017, 10019, 10027, 10023, 10025, 10029, 10032, 10034, 10036, 10037, 10075, 0301, 10304, 10305, 10312, 10451, 10452, 10455, 10457, 10458, 10459, 10461, 10462, 10463, 10464, 10466, 10469, 10508, 10523, 10604, 10952, 11042, 11102,  11103, 11104, 11203, 11204, 11206, 11207, 11208, 11209, 11210, 11212, 11213, 11214, 11215, 11216, 11218, 11219, 11220, 11223, 11224, 11226, 11228, 11229, 11230, 11234, 11235, 11236, 11237, 11238,  11354, 11355, 11358, 11360, 11361, 11362, 11364, 11365, 11368, 11372, 11373, 11374, 11375, 11377, 11385, 11411, 11416, 11418, 11419, 11423, 11427, 11432, 11435, 11436, 11691, 11772, 11940 Various Counties
 Steven Lee

✉ Email Address

ZIP Codes: 10002, 10013, 10314

Counties: Manhattan, Richmond

Providers: Charles B. Wang Community Health Center, CAIPA Manhattan Providers, Excelsior Empire Health Manhattan Providers, CAIPA Staten Island Providers


Upstate Regions:

Name Coverage Area
Assigned Providers
 Jane Sanderson

✉ Email Address

Counties: Dutchess, Saratoga, Schenectady, Washington Albany County Providers: Whitney Young, Northern Medical Group


 Barbara Bentley-Morrill

✉ Email Address

Counties: Albany, Clinton, Columbia, Essex, Green, Warren, All Vermont Providers: All Vermont Providers, Saratoga Hospital, Saratoga Regional Medical, Twin Rivers Medical

 Jaime Laube

✉ Email Address

Counties: Orange, Putnam, Rensselaer, Sullivan, Ulster

Providers: Hudson Valley Regional Community Health. Montefiore Medical Center, Union Community Health Center
 Penny Patterelli

✉ Email Address

Counties: Oneida, Onondaga, Otsego, Schoharie IPA: Trinity Health
Providers: St. Peters' Health Partners Medical Associates, Samaritan Hospital of Troy, St. Peter's Hospital, St. Joseph's Hospital Health Center, St. Joseph Medical PC.  Other: Family Care Medical Group, Crouse Medical Practice,  Family Care Medical Group, Mary Imogene Bassett, Little Falls Hospital, Mohawk Valley Health System, Rome Health
 Nicole Heldson
✉ Email Address
Counties: Genesee, Livingston, Niagara, Ontario, Orleans, Wyoming IPA: GLIN

Providers: Bertrand Chaffee Hospital, Bradford Regional Medical Associates (Upper Allegany Health System), ECMC, General Physicians,  Kaleida Health , Niagara Falls Memorial Medical Center, Olean General Hospital, UB Family Medicine INC dba UBMD Primary Care, Wyoming Community Hospital, Paul DeJac, Christopher Beney , Amandeep Pal, Oak Orchard Health, Anthony Jordan, FLH, Geneva Hospital, Finger Lakes Health Center
 Sarah Freyer

✉ Email Address

Counties: Franklin, Fulton, Hamilton, Herkimer, Montgomery, Saint Lawrence Providers: St. Regis Mohawk Tribe, Benardot Tribe, Nathan Littauer Hospital, North County Family, Carondelet, St. Mary's
 Maureen Hudson

✉ Email Address

Erie County  IPA: CIPA (Catholic Medical Partners) 

Catholic Medical Partners (CMP) Sisters Of Charity Hospital, Mount St. Mary's Hospital , Trinity Medical of WNY, PC., WNY Medical PC, Primary Care of WNY, Summit Pediatrics, Lockport Pediatrics, Frank Laurri, M.D. & Associates, Southgate Medical Group                             
 Christine Santiago
✉ Email Address
Counties: Allegany, Cattaraugus, Chautauqua, Chemung, Steuben, Yates IPA: Primary Care IPA

Providers: Family Health Medical Services, PLLC, Highgate Medical Group, PC., Northeast Medical, PC, Kenmore Family Medicine, Wheatfield Pediatrics, Delaware Pediatrics, Buffalo Pediatrics Other: Jones Memorial Hospital , Jones Memorial Services (U of R) Jamestown Pediatric , Southern Tier Pediatrics, Great Lakes Physicians Practice, PC, Community Inclusion Inc, Keuka Family Practice, Wayland Family & Sports Med, Gurdeep Kundlas, MD, Arnot Health UPMC of Chautauqua, Soldiers & Sailors
 Christine Jendraszek

✉ Email Address

Various Counties
IPA: CINQ Upstate and Downstate

Providers:  AEHS, INC.,Care Medical Practice, Community Health Center of Buffalo, Jericho Road Ministries, Medical Health Associates for Western NY, INC.  Southertier Community Health Center Networks, INC., The Chautauqua Center, INC, Tri-County Family Medicine Program, INC., Lakeshore Family Medicine Associates, Liberty Resources, Ted J. Triana, Urban Family Practice, Westfield Family Physicians, John Mulawka-dba Southtowns Pediatrics, Lynne Ross dba Canalside Primary Care, Mobile Physicians Services PLLC, Robert Ericson Do &Jennifer Ericson Do dba Inspired Health Group
 Robert Chantra

✉ Email Address

Counties: Monroe, Wayne IPA: GRIPA, Guthrie

Providers: Rochester Regional Health System- (RRHS) Rochester General Hospital, The Unity Hospital of Rochester United Memorial Medical Center, Western New York Medical Practice, Clifton Springs Hospital & Clinic, Newark Wayne Community Hospital (St. Lawrence Health Systems) Massena Hospital, Canton Potsdam Hospital & Medical Practice, Gouverneur Hospital Guthrie Health-Guthrie Corning Hospital, Guthrie Cortland Medical Center, Guthrie Robert Packer Hospital, Guthrie Troy Hospital University of Rochester (U of R) Strong Memorial Hospital         
 Nicole Lloyd

✉ Email Address

Counties: Cayuga, Jefferson IPA: Main Street Rural

Providers: Auburn Community Hospital, all of Cayuga County and Jefferson County
 Karen Yonkers-Santy

✉ Email Address

Counties: Cortland, Oswego, Schuyler, Seneca, Tioga, Tompkins IPA: Cayuga Health Partners, FLIPA, NYSMG

Providers: FLIPA- Family Health Network of CNY, Northern Oswego County Health Services Inc., Upstate Family Health Center, Inc. Other: Cayuga Medical Associates, Oswego County OB-GYN, New York Senior Medical Group
 Peter Stone

✉ Email Address

Counties: Broome, Chenango, Delaware, Lewis, Madison IPA: Concordia                                                                                       
Providers: United Health Services (UHS) Chenango Memorial Hospital INC, Delaware Valley Hospital INC, United Health Services Hospitals, INC, United Medical Associates. Concordia- Oneida Medical Practice PC, Oneida Health Systems INC, Oneida Medical Associates PLLC. Other: Endwell Family Physicians, Lewis County General Hospital

Provider Quality News


National Pharmacy Week: Improving Patient Outcomes
10/16/2024 • Posted by Fidelis Care in Health and Wellness

Brett Douglas picture
(Brett Douglas, PharmD, AAHIVP, Fidelis Care Clinical Pharmacy Team Lead)


National Pharmacy Week is October 20 to 26. It’s a time to recognize the crucial role that pharmacists and technicians play in keeping our communities healthy. From personalized care to medication management, pharmacists and pharmacy workers are essential to improving patient outcomes and overall well-being. In observance of National Pharmacy Week, Fidelis Care talked with Clinical Pharmacy Team Lead Brett Douglas about his career journey.


Fidelis Care: What inspired you to enter the pharmacy profession, and what do you find rewarding about it?

Douglas: My grandfather, W.C. “Pa-Paw” Mangum, was a pharmacist starting in the 1930s in the small rural town of Magee, Mississippi. He died before I was born so I never got to meet him. I heard many stories from my mom about how he would make house calls in the middle of the night, which is not something we think of pharmacists doing today. This was in a very small town and the profession was different then. I got a job at a pharmacy when I was in high school, and I was hooked – I loved helping patients. Working as a pharmacist is so rewarding. It allows me to be kind to someone who is likely not feeling so great and just wants to feel better.


Fidelis Care: What are your day-to-day duties at Fidelis Care? How do you help members stay healthy?

Douglas: My daily duties can vary. Between drug recalls, regulatory changes, and new drug launches, our team must be flexible and ready to accommodate any changes in the pharmacy industry during a given week. I am fortunate to work with amazing Pharmacists, as well as Care Managers who speak to our members to help them in very real ways to get and stay healthy. The “magic” happens when I have a conversation with a provider and get a better understanding of a member’s clinical picture. I can then pass that information on to the member’s Care Manager, which allows them to help the member in a focused, informed way. One specific example is my work helping members living with HIV. If I speak to a provider, making sure the member is on an appropriate HIV regimen but needs updated lab work, I often follow up later and can see in the medical record that the patient came in for labs and their HIV is under control. We have come a long way in HIV care, but unfortunately stigma is still a significant barrier to care. If I play any part in getting a member’s HIV to undetectable, it means the world to me and is why I love being an HIV pharmacist. It’s personal to me and to my community.


Fidelis Care: What is your advice to young people interested in a career in pharmacy?

Douglas: Even if your goal is to be a clinical or hospital pharmacist, spend some time in retail pharmacy. It’s important to understand what your fellow pharmacists in the retail setting do to help patients, even if your career takes you down a different path. While it’s important to keep up with the latest developments and clinical studies, don't underestimate the importance of creative thinking skills as well. Problem solving is not always about deciphering the statistics – often you need to take a step back and evaluate a situation from a different point of view. Don’t let fear of being wrong keep you from asking questions of your teachers, colleagues, and mentors.  


Fidelis Care: What is your message in observance of National Pharmacy Week?

Douglas: National Pharmacy Week is a time to take a moment and think about people in your life – teachers, mentors, current colleagues – who inspire you to be the best pharmacist you can be. If there is someone in your life who has made a significant impact in the way you practice pharmacy – reach out to them and let them know how much they inspired or continue to inspire you.


Brett Douglas, PharmD, AAHIVP, is the Fidelis Care Clinical Pharmacy Team Lead. He supports Case Management for members living with multiple health conditions such as HIV, Sickle Cell Disease, and Hemophilia. In addition, he works in the development and administration of Quality-related outreach campaigns based on QARR/HEDIS measures. Brett received his Doctor of Pharmacy degree from the University of Mississippi (Ole Miss). Before joining Fidelis Care, he worked in a Specialty Community pharmacy in New York City for 17 years and served a large population of patients living with HIV, among other specialty conditions.


Additional Resources:

Fidelis Care Pharmacy Benefit

Provider Office Hours

Fidelis Care hosts webinars called “Provider Office Hours” several times each month to share information and answer any of your questions. 

Provider Satisfaction Survey

Your provision of quality care and services to our members contributes greatly to Fidelis Care’s success. One of the ways Fidelis Care prioritizes quality is making sure you are satisfied with your experiences. Our annual Provider Satisfaction Survey identifies areas to focus on for further improvement in the coming year. The Provider Relations Department works diligently to identify an action plan to address areas of improvement, while continuing to develop actions and interventions to improve the provider experience.

HEDIS® Measurement Toolkit

HEDIS® is a tool used by more than 90% of America’s health plans to measure performance on important dimensions of care and service. We've developed this toolkit to help identify required preventive services.


Resources

Fidelis Care offers resources including Provider Bulletins, tip sheets, educational materialsblog posts, and more to keep you informed.

Provider Tip Sheets - Quality

Quality

Adult Wellness Visit Tip Sheet

Behavioral Health Case Management Services Tip Sheet

Behavioral Health Follow-Up Measures

Breast Cancer Screening Tip Sheet

Child and Adolescent Well Care Visits Tip Sheet

Childhood Immunization Status Tip Sheet

Closing the Gap on Follow-Up Care After Discharge

Colorectal Cancer Screening Tip Sheet

Continuity of Care Tip Sheet

Controlling High Blood Pressure Tip Sheet

Depression Screening and Follow-Up for Adolescents and Adults

Flu Shot for Adults Tip Sheet

Follow-up Care for Children Prescribed ADHD Medication (ADD) Tip Sheet

Glycemic Status Assessment for Patients with Diabetes (GSD) Tip Sheet

HEDIS® Tip Sheet 2021 Antidepressant Medication Management (AMM)

HEDIS® Immunizations for Adolescents Combination 2 (IMA-2)

Importance of Chlamydia Screening Tip Sheet

Importance of Follow-Up Care for Mental Illness

Improving Cardiometabolic Health for Members with Diabetes Tip Sheet

Kidney Health Evaluation for Patients with Diabetes (KED) Tip Sheet

Low Back Pain Tip Sheet

Metabolic Monitoring for Children and Adolescents on Antipsychotics Tip Sheet

Patient Satisfaction Surveys Tip Sheet

Postpartum Depression Screening and Follow-up Tip Sheet

Preventive Cancer Screenings and Vaccines Tip Sheet

Primary Care Provider (PCP) Quality Tip Sheet

Psychiatric Collaborative Care Model

Smoking Cessation Provider Tip Sheet

Telehealth Guide for Health Home Care Managers

Telehealth Tip Sheet

Transitions of Care (TRC) Tip Sheet

Viral Load Suppression Tip Sheet

Well Child - Birth to 30 Months Well Care Visits Tip Sheet

Wellcare Partnership for Quality Program - 2026

Quality Policies

 

Latest Provider Bulletin

 


Provider Bulletin Archives ➔


Fidelis-Care-Summer-Health-Newsletter