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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 Nurses Week: A Celebration of Compassion and Care
5/6/2024 • Posted by Fidelis Care in Health and Wellness, In The Community, Member News

On this National Nurses Week May 6-12, Fidelis Care celebrates the invaluable contributions of nurses everywhere. This week gives us the opportunity to recognize the dedication, compassion, and commitment that nurses bring to our healthcare system. In honor of these contributions, Fidelis Care showcases the outstanding efforts that 10 of our own nurses bring to their profession every day:


Danielle Albring
Danielle Albring, RN, Long Term Nurse Care Specialist
Nursing allows me to make a positive impact on people’s lives, and I find that very rewarding. Nursing keeps me going through adversity. At the end of my day, it is not about what I have accomplished for the day. It is about who I was able to lift up, who I helped, and how their lives will be better because of my effort.


Mary Batug
Mary Batug, RN, Case Manager – Care Specialist II
As a transplant case nurse at Fidelis Care, I have the opportunity to combine my clinical knowledge from working in a hospital with my knowledge of insurance case management to support our members throughout the transplant process. It is very rewarding to help a member navigate the process for these lifesaving procedures and go on to live their lives.


Sally Bourne
Sally Bourne, RN, Clinical Review Clinician
Going into nursing turned out to be the best choice I ever made. It is rewarding and fulfilling to be able to help others and make a difference in their lives. Opportunities in nursing are diverse and have allowed me to positively impact people both in direct patient care and in my roles at Fidelis Care through the years.


Beverly Kasowski
Beverly Kasowski, RN, Clinical Review Nurse
I have always had a calling to help others and their families. Coming from a large family of 18 children and dealing with several losses of siblings, I decided to become a nurse at a young age. My goal was to assist and teach as much as I can. I became a Registered Nurse in 1998, specializing in nursery and eventually earning my certification in case management. I absolutely love being a Fidelis Care nurse and am grateful every day to be able to encourage and guide members along their health journeys.


Sharda King
Sharda King, RN, Behavioral Health Clinician
My nursing career serves as a profound source of satisfaction in my life, intertwining my passion for compassionate care with a deep sense of purpose. Each day, I am privileged to make a positive impact on the lives of others, providing connection to resources that will positively impact people’s mental and physical health, and support them during their most vulnerable moments. The continuous learning and growth inherent in nursing foster a dynamic environment where I am constantly challenged and inspired to expand my skills and knowledge. Ultimately, knowing that my contributions directly enhance the quality of life for those in need enriches me both personally and professionally.


Tiffany Majtyka
Tiffany Majtyka, RN, Case Manager – Care Specialist II
Nursing became my second career, as I wanted to give my kids more than I previously could. My two sons, ages 2 and 5 at the time, moved with me across the country so I could go to nursing school. Being a nurse has allowed me to buy a home, provide for my family, and, most of all, make a difference in people’s lives. I came to Fidelis Care after 13 years working in a hospital. I now link families to programs that help them succeed. I love what I do and there is nothing better than a parent telling you that you have made a positive impact on their family.


Ana Martinez
Ana Martinez, RN, Care Manager – Fidelis Care at Home
In my 12 years as a nurse, I have had the privilege of helping others when they are at their most vulnerable. Serving as a volunteer with the Dominican Red Cross when I was a teenager gave me the passion to help others and decide that nursing was the path to do what I love. When I moved to the United States, I enrolled in a nursing program, not knowing the challenges I would face with English as my second language. Working as a Nurse Care Manager at Fidelis Care allows me to assist members with their medical, social, and safety needs. The most satisfying thing about being a nurse is making a difference in the lives of others. Knowing that my care, voice, and time can help a patient make it through is one of the most rewarding feelings.



Jamie Miller, RN, Manager – Clinical
I chose to become a nurse because I have always felt a strong desire to help others and make a positive impact in people’s lives. As a clinical manager alongside my team of nurses, we aim to provide the highest quality compassionate care to our members. Seeing the positive impact on a member’s well-being and enhancing their care experience reminds me daily of why I chose this meaningful career path.


Jacob Mrugalski
Jacob Mrugalski, RN, Lead Clinical Reviewer
After six years in the IT field, I decided to pursue a career in nursing so I could use my skills and talents to truly make a difference in the lives of others. I am overjoyed to say my current role at Fidelis Care is a perfect fit for me, as it allows me to use my experience in the IT field while also giving me a strong sense of fulfillment by serving our members. Becoming a nurse was the best decision I’ve ever made, and I look forward to many more wonderful years with Fidelis Care!



Jennifer Mruk, RN, Case Manager - Health and Recovery Plan
I work as a Fidelis Care Health and Recovery Plan (HARP) Case Manager with the diabetes team, specifically working on the Medical Optimization, Results, and Empowerment (MORE) initiative. I knew from early childhood that I wanted to be a nurse. I have always been passionate about helping and caring for others. For me, nursing brings great satisfaction because I’m able to provide the care and support members need to address their overall health and well-being.  

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