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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

Quality Care Incentives (QCI) Program

Fidelis Care's QCI Program rewards groups/practices for providing recommended preventive care, for caring for members with chronic disease, and for comprehensive obstetrical care. As your health plan partner, we remain committed to rewarding our providers for achieving high-quality outcomes and have made significant changes to the program for measurement year 2024 to align with our shared goals, encourage participation, and recognize regional differences within New York State.

Fidelis Care’s Quality Care Incentives (QCI) Program is available on Provider Access Online. Once logged in, please navigate to the File Downloads section to access the brochure.

Within the brochure, we are providing a summary of the components of our QCI Program, along with the associated coding specifications, to help you drive improvements in quality and to reward you for your efforts. Fidelis Care also provides monthly care gap reports to track your incremental performance, and identify those patients who may benefit from needed care and services.

If you have any questions regarding Fidelis Care’s Quality Care Incentives, please contact your Provider Partnership Associate.



Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Provider Partnership Associates - Quality
NYC Region:

Name Coverage Area Assigned Counties and/or Providers
 OPEN
Brianni Blue Loftlin (Covering)

✉ Email Address

Zinaida Khavasova (Covering)    ✉ Email Address

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

✉ Email Address

Brooklyn County ZIP Codes: 10013, 10002, 11220, 11219, 11204, 11214 Brooklyn County
 Zinaida Khavasova

✉ Email Address

Kings County ZIP Codes: 11204, 11209, 11210, 11214, 11218, 11219, 11223, 11224, 11228, 11229, 11230, 11232, 11234, 11235, 11236, 11239  Kings County
 Michael Gayle

✉ Email Address

Bronx County ZIP Codes: 10456, 10458, 10461, 10459, 10465, 10475, 10455, 10454, 10464, 10471, 10474, 10470, 10803, 10499, 10453, 10468, 10468, 10457, 10452, 10469, 10462, 10466, 10473 Bronx County


 Stanley Laforest

✉ Email Address

Manhattan County 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 Manhattan County
OPEN
Taylor Panzarella (Covering)

✉ Email Address

Osaruyi Eduwen (Covering)

✉ Email Address

Rosemond Guillaume (Covering)

✉ Email Address

Brooklyn County ZIP Codes: 11238, 11212, 11236, 11234
Providers: NYU, Mt.Sinai, NY Presby, NYNM
 Osaruyi Eduwen

✉ Email Address

Queens County ZIP Codes: 11101, 11102, 11103, 11104, 11105, 11106, 11368, 11369, 11370, 11371, 11372, 11373,1 1374, 11375, 11377, 11378, 11379, 11385 Queens County
 Kellimar James-Nixon

✉ Email Address

Queens County ZIP Codes: 11004, 11354, 11355, 11356, 11357, 11358, 11360, 11361, 11362, 11363, 11364
Queens County
 Rosemond Guillaume

✉ Email Address

Queens County 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
Queens County

 OPEN
Rosemond Guillaume (Covering) ✉ Email Address

Haneefah Mahdi (Covering)
✉ Email Address


Rockland and Westchester County ZIP Codes: 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
 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
 Susan Jacob

✉ Email Address

Suffolk County ZIP Codes: 11702, 11706, 11705, 11716, 11717, 11719, 11933, 11934, 11720, 11721, 11722, 11724, 11725, 11727, 11729, 11730, 11731, 11772, 11941, 11738, 11946, 11788, 11743, 11746, 11749, 11751, 11752, 11754, 11755, 11948, 11757, 11949, 11950, 11951, 11763, 11747, 11954, 11766, 11767, 11701, 11703, 11713, 11777, 11961, 11901, 11778, 11779, 11962, 11782, 11784, 11733, 11787, 11780, 11790, 11704, 11795, 11796, 11977, 11978, 11798, 11980  Suffolk County


Upstate Regions:

Name Coverage Area
Assigned Counties and/or Providers
 Jane Sanderson

✉ Email Address

Rensselaer County ZIP Codes: 12180, 12144, 12182, 12061, 12033, 12198, 12090, 12179, 12018, 12123, 12196, 12154, 12138, 12121, 12094, 12185, 12168, 12062, 12052, 12156, 12140, 12153, 12028 ,12057, 12022 12169, 12063, 12082, 12181, 12089, 12133, 12040                                                                                   

Saratoga County ZIP Codes
: 12065, 12866, 12020, 12010,  12831, 12118, 12019, 12188, 12828, 12803, 12148, 12822, 12170, 12871, 12025, 12833, 12134, 12027, 12850, 12074, 12859, 12835, 12151, 12863, 12086,  12884 

Schenectady County ZIP Codes:  12008, 12053, 12056, 12137 , 12141, 12150, 12301, 12302, 12303 ,12304, 12305 , 12306 ,12307, 12308, 12309, 12325, 12345 

Washington County ZIP Codes:  12839, 12828, 12834, 12832, 12887, 12827, 12816, 12865, 12809, 12154, 12094, 12821, 12185, 12028, 12057, 12837, 12873, 12861, 12819, 12823, 12838, 12849, 12841, 12844, 12848, 12854     
Counties: Rensselaer, Saratoga, Schenectady, Washington
 Barbara Bentley-Morrill

✉ Email Address

Albany County ZIP Codes: 12309, 12203, 12205, 12303, 12047, 12208, 12304, 12110, 12189, 12054, 12206, 12211, 12210, 12209, 12009, 12202, 12159, 12204, 12077, 12158, 12186, 12143, 12084, 12053, 12083, 12111, 12183, 12262, 12222, 12023, 12067, 12207, 12193, 12059, 12087, 12469, 12046, 12120, 12147, 12226, 12460, 12041, 12234, 12085, 12007, 12201, 12212, 12214, 12220, 12223, 12224, 12225, 12227, 12228, 12229, 12230, 12231, 12232, 12233, 12235, 12236, 12237, 12238, 12239, 12240, 12241, 12242, 12243, 12244, 12245, 12246, 12247, 12248, 12249, 12250, 12255, 12257, 12260, 12261, 12288, 12107, 12128, 12161, 12045, 12055

Clinton County ZIP Codes:  12901, 12972, 12962, 12918, 12992, 12919, 12944,  12981, 12910, 12958, 12921, 12935, 12912, 12903, 12979, 12929 ,12959, 12985, 12934, 12923, 12955, 12952, 12911, 12924, 12978, 12933 

Columbia County ZIP Codes: 12534, 12571, 12184, 12526, 12037, 12075, 12546, 12106, 12529, 12583, 12567, 12060, 12173, 12516, 12521, 12523, 12156, 12125, 12029, 12502, 12136, 12565, 12503, 12017, 12130, 12513, 12517, 12115, 12024, 12165, 12132, 12593, 12174, 12530, 12195, 12172, 12050, 12541, 12544

Essex County ZIP Codes: 12983, 12946, 12883, 12944, 12928, 12912, 12870, 12941, 12960, 12974, 12996, 12932, 12997, 12993, 12943, 12950, 12851, 12936, 12987, 12913, 12956, 12857, 12852, 12942, 12998, 12964, 12961, 12855, 12858, 12975, 12977, 12872, 12879 

Greene County ZIP Codes: 12414, 12051, 12143, 12083, 12015, 12413, 12192, 12496, 12058, 12463, 12431, 12468, 12451, 12087, 12430, 12423, 12473, 12427, 12436, 12442, 12405, 12480, 12418, 12470, 12424, 12450, 12444, 12485, 12492, 12482, 12422, 12454, 12407, 12460, 12042, 12176, 12439, 12490, 12452, 12124   

Warren County ZIP Codes: 12804, 12801, 12845, 12885, 12846, 12817, 12853, 12814, 12856, 12843, 12815, 12824, 12878, 12808, 12836, 12810, 12860, 12874, 12844, 12862, 12886, 12811, 12820  
Counties: Albany, Clinton, Essex, 
Columbia, Greene, Warren
 Jaime Laube

✉ Email Address

Orange County ZIP Codes: 10950, 12550, 10940, 12553, 10990, 12589, 10941, 10924, 12771, 10918, 12566, 12549, 10980, 12586, 10930, 10992, 10928, 12721, 12518, 10963, 10916, 10998, 10921, 10987, 10925, 12575, 10958, 10926, 12577, 12780, 12520, 10973, 10986, 12729, 12746, 12543, 10969, 10996, 10917, 10919, 10975, 10914, 10922, 10933, 12785, 10911, 10943, 10985, 10910, 10912, 10915, 10932, 10949, 10953, 10959, 10979, 10981, 10988, 10997, 12551, 12552, 12555, 12584  

Putnam County ZIP Codes: 10541, 10512, 10509, 12563, 10579, 10516, 10524, 12531, 10588, 10537, 10542

Sullivan County ZIP Codes: 12701, 12721, 12754, 12790, 12758, 12788, 12747, 12776, 12783, 12775, 12764, 12723, 12789, 12729, 12768, 12740, 12748, 12737, 12779, 12763, 12734, 12726, 12719, 12733, 12759, 12732, 12777, 12765, 12751, 12760, 12762, 12786, 12725, 12766, 12742, 12743, 12770, 12785, 12778, 12741, 12720, 12745, 12738, 12750, 12724, 12749, 12736, 12769, 12787, 12791, 12792, 12752, 12767, 12781, 12784, 12722, 12727  

Ulster County ZIP Codes:  12401, 12477, 12561, 12589, 12528, 12566, 12428, 12446, 12542, 12758, 12443, 12487, 12498, 12404, 12525, 12547, 12449, 12484, 12466, 12458, 12548, 12455, 12440, 12491, 12461, 12740, 12486, 12515, 12409, 12494, 12472, 12464, 12406, 12481, 12410, 12480, 12456, 12457, 12433, 12725, 12411, 12419, 12435, 12495, 12416, 12412, 12448, 12475, 12429, 12465, 12493, 12490, 12471, 12441, 12489, 12483, 12782, 12402, 12417, 12420, 12432, 12453, 12568, 12588  
Counties: Orange, Putnam,
Sullivan, Ulster
 Penny Patterelli

✉ Email Address

Oneida County ZIP Codes: 13440, 13501, 13502, 13413, 13421, 13323, 13492, 13403, 13316, 13309, 13308, 13354, 13476, 13478, 13480, 13456, 13438, 13495, 13471, 13461, 13042, 13424, 13417, 13363, 13318, 13425, 13490, 13431, 13054, 13304, 13477, 13338, 13328, 13303, 13322, 13321, 13486, 13441, 13469, 13319, 13494, 13440, 13501, 13502, 13413, 13421, 13323, 13492, 13403, 13316, 13309, 13308, 13354, 13476, 13478, 13480, 13456, 13438, 13495, 13471, 13461, 13042, 13424, 13417, 13363, 13318, 13425, 13490, 13431, 13054, 13304, 13477, 13338, 13328, 13303, 13322, 13321, 13486, 13441, 13469, 13319, 13494, 13483, 13157, 13455, 13352, 13162, 13301, 13435, 13341, 13362, 13401, 13313, 13123, 13442, 13449, 13479, 13503, 13504, 13505, 13599  

Otsego County ZIP Codes:  13820, 13326, 13849, 13439, 13491, 13411, 13825, 12197, 13843, 13320, 12155, 13809, 13807, 13810, 13335, 13315, 13808, 13750, 12116, 13485, 13348, 13796, 13361, 13337, 13468, 13861, 12064, 13776, 13450, 12036, 13342, 13333, 13415, 13488, 13859, 13860, 13457, 13482, 13747, 13834   

Schoharie County ZIP Codes: 12043, 12053, 12122, 12157, 12149, 12023, 13459, 12066, 12093, 12167, 12092, 12076, 12469, 12160, 12187, 12175, 12035, 12064, 12031, 12036, 12194, 12071, 12131, 12073

Counties: Oneida, Otsego,
Schoharie
 Jeannie Vanhoeven

✉ Email Address

Fulton County ZIP Codes: 12010, 12078, 12095, 12025, 13452, 13329, 12117, 12070, 12032, 12086, 13470 

Franklin County ZIP Codes: 12953, 12983, 12986, 12966, 13655, 12920, 12926, 12916, 12957, 12937, 12917, 12980, 12989, 12914, 12970, 12945, 12930, 12976, 12913, 12955, 12969, 12995, 12915, 12939, 13683   

Hamilton County ZIP Codes: 12134, 13324, 12842, 13454, 12856, 12032, 12108, 12847, 12190, 13360, 12139, 13436, 12812, 12164, 13353, 12864

Montgomery County ZIP Codes: 12010, 13339, 13452, 13317, 12068, 12072, 12070, 12066, 12166, 12137, 13428, 12086, 12177, 13410, 12069, 12016  

Saint Lawrence County ZIP Codes: 13662, 13676, 13669, 13617, 13642, 12986, 13667, 13668, 13658, 13646, 13613, 13654, 13697, 13625, 13648, 13679, 13660, 13652, 13630, 13684, 13694, 13680, 13681, 12980, 13621, 12967, 13635, 12914, 13690, 13687, 13672, 13670, 13633, 12927, 12965, 13614, 13666, 13695, 13664, 12922, 13639, 12973, 13649, 12949, 13623, 13645, 13647, 13677, 13678, 13696, 13699 
Counties: Fulton, Franklin, Hamilton,
Montgomery, Saint Lawrence
 Sarah Freyer

✉ Email Address

Dutchess County ZIP Codes: 12603, 12601, 12590, 12533, 12508, 12524, 12538, 12569, 12571, 12572, 12540, 12564, 12570, 12582, 12522, 12545, 12580, 12531, 12594, 12546, 12581, 12514, 12501, 12583, 12578, 12567, 12592, 12585, 12507, 12604, 12574, 12602, 12504, 12506, 12510, 12511, 12512, 12527, 12537
Dutchess County
 Maureen Hudson

✉ Email Address

Erie County ZIP Codes: 14004, 14026, 14031, 14043, 14051, 14059, 14086, 14094, 14202, 14203, 14206, 14209, 14212, 14214, 14215, 14216, 14217, 14220, 14225, 14226 Erie County

Providers: Kaleida, General Physicians 

VBP IPAs:  CINQ, CIPA, and GLIN
 Christine Pinelli

✉ Email Address

Allegany County ZIP Codes: 14895, 14727, 14813, 14739, 14880, 14807, 14806, 14735, 14715, 14804, 14770, 14803, 14065, 14744, 14717, 14709, 14711, 14846, 14836, 14060, 14822, 14536, 14897, 14754, 14777, 14714, 14708, 14884, 14802, 14721, 14707, 14774, 14029, 14745, 14786

Cattaraugus County ZIP Codes
: 14760, 14141, 14779, 14070, 14009, 14706, 14727, 14737, 14042, 14719, 14738, 14772, 14755, 14741, 14770, 14138, 14747, 14171, 14101, 14726, 14743, 14129, 14065, 14731, 14060, 14753, 14729, 14748, 14783, 14173, 14041, 14788,14133, 14168, 14730, 14751, 14766, 14778    

Chautauqua County ZIP Codes: 14701, 14048, 14063, 14136, 14750, 14787, 14733, 14062, 14710, 14738, 14081, 14712, 14757, 14775, 14724, 14781, 14767, 14716, 14138, 14782, 14747, 14726, 14718, 14723, 14728, 14784, 14769, 14740, 14720, 14722, 14736, 14135, 14166, 14742, 14785, 14702, 14732, 14752, 14756, 14758 

Erie County ZIP Codes
: 14006, 14043, 14047, 14052, 14057, 14075, 14111, 14127, 14141, 14218, 14224 

Wyoming County ZIP Codes: 14004, 14011, 14569, 14530, 14009, 14525, 14550, 14040, 14427, 14024, 14591, 14167, 14145, 14066, 14037, 14536, 14113, 14082 14039, 14549, 14083, 14130        
Counties: Allegany, Cattaraugus,
Chautauqua, Erie, Wyoming
 Christine Jendraszek

✉ Email Address

Erie County ZIP Codes:  14001, 14032, 14150, 14201, 14208, 14219, 14221, 14223, 14227 and 14228

Genesee County ZIP Codes: 14020, 14482, 14036, 14125, 14416, 14422, 14525, 14005, 14058, 14040, 14591, 14013, 14054, 14143, 14056, 14021 and 14557  

Livingston County ZIP Codes: 14454, 14437, 14472, 14414, 14510, 14487, 14572, 14423, 14485, 14435, 14517, 14533, 14560, 14466, 14481, 14846, 14836, 14822, 14462, 14480, 14486, 14556, 14545, 14592, 14488, 14539 and 14558           

Steuben County ZIP Codes: 14830, 14843, 14810, 14437, 14870, 14801, 14572, 14871, 14823, 14840, 14821, 14812, 14807, 14806, 14873, 14826, 14809, 14879, 14898, 14858, 14820, 14839, 14819, 14855, 14885, 14815, 14877, 14874, 14808, 14893, 14827, 14831, 14529 and 14856                                                                                                                              Wyoming County ZIP Codes:  14004, 14011, 14569, 14530, 14009, 14525, 14550, 14040, 14427, 14024, 14591, 14167, 14145, 14066, 14037, 14536, 14113, 14082 14039, 14549, 14083 and 14130        

Counties: Erie, Genesee, Livingston,
Steuben, Wyoming
 Nicole Helsdon

✉ Email Address

Monroe County ZIP Codes: 14580, 14450, 14609, 14624, 14612, 14534, 14621, 14626, 14606, 14618, 14623, 14616, 14620, 14617, 14468, 14526, 14420, 14615, 14559, 14607, 14611, 14613, 14619, 14610, 14622, 14608, 14586, 14605, 14467, 14625, 14428, 14472, 14664, 14445, 14464, 14546, 14673, 14514, 14543, 14604, 14627, 14614, 14683, 14506, 14511, 14645, 14508, 14515, 14410, 14430, 14694, 14602, 14603,14638, 14639, 14642, 14643, 14644, 14646, 14647, 14649, 14650, 14651, 14652, 14653, 14692

Niagara County ZIP Codes:  14094, 14120, 14304, 14305, 14301, 14092, 14303, 14132, 14174, 14105, 14131, 14108, 14067, 14172, 14012, 14008, 14028, 14126, 14095, 14107, 14109, 14144, 14302, 14222 

Orleans County ZIP Codes: 14411, 14103, 14470, 14105, 14098, 14476, 14058, 14477, 14571, 14479, 14429, 14452   
Counties: Monroe, Orleans, Niagara

Providers - Erie County: Jericho
 Road Ministries, Genesee Transit Pediatrics,
and Paul DeJac                                                                                         
VBP IPAs: SNAPCAP
 Robert Chantra

✉ Email Address

Ontario County ZIP Codes: 14424, 14456, 14564, 14425, 14522, 14469, 14432, 14487, 14548, 14512, 14532, 14485, 14561, 14471, 14560, 14544, 14466, 14504, 14475, 14537, 14585, 14461, 14463, 14518, 14443, 14453, 14547
Ontario County

Providers: GRIPA (all counties) & Guthrie
and University of Rochester     

VBP IPAs:  FLIPA, GRIPA, Guthrie 
 Andre Burton

✉ Email Address

Seneca County ZIP Codes:  14850, 14456, 13165, 13148, 14886, 14532, 14521, 13146, 14847, 14541, 14860, 14841, 13065, 14588

Schuyler County ZIP Codes: 14886, 14837, 14891, 14812, 14865, 14818, 14864, 14869, 14878, 14824, 14805, 14841, 14815, 14876, 14887, 14863

Wayne County ZIP Codes:  14513, 14519, 14502, 14522, 14489, 14589, 14568, 14551, 14505, 14433, 14590, 13143, 13146, 14516, 14555, 13154, 14520, 14538, 14542, 14413, 14449, 14563 
Counties:  Seneca, Schuyler, Wayne

Providers: Arnot                                                                   

VBP IPAs:  NCI   
 Karen Yonkers-Santy

✉ Email Address

Cortland County ZIP Codes: 13045, 13077, 13159, 13803, 13053, 13040, 13101, 13835, 13052, 13158, 13141, 13863, 13841, 13087, 13738, 13056, 13784

Oswego County ZIP Codes: 13126, 13069, 13036, 13114, 13142, 13135, 13074, 13167, 13132, 13131, 13044, 13042, 13493, 13076, 13111, 13083, 13661, 13302, 13145, 13144, 13028, 13437, 13103, 13426, 13093, 13107, 13115, 13121                                

Tioga County ZIP Codes:
  13760, 13827, 14892, 13732, 13811, 14883, 13743, 13812, 13736, 13734, 13835, 13864, 14859, 13840, 13845            

Tompkins County ZIP Codes: 14850, 13068, 14886, 13073, 14867, 13053, 14883, 14882, 13736, 14817, 13864, 14853, 14881, 14852, 13062, 13102, 14851, 14854
Counties: Cortland, Oswego, Tioga,
Tompkins
 Peter Stone

✉ Email Address

Onondaga County ZIP Codes: 13027, 13090, 13210, 13208, 13212, 13088, 13204, 13039, 13203, 13205, 13206, 13031, 13104, 13057, 13219, 13215, 13207, 13041, 13066, 13209, 13078, 13260, 13224, 13152, 13214, 13029, 13202, 13077, 13108, 13211, 13135, 13159, 13084, 13082, 13080, 13120, 13030, 13116, 13110, 13164, 13060, 13063, 13112, 13141, 13122, 13020, 13153, 13201, 13217, 13218, 13220, 13221, 13225, 13235, 13244, 13250, 13251, 13252, 13261, 13290, 13051, 13089, 13119, 13137, 13138 Onondaga County                                                                                         
APP Groups (Wellcare ONLY): 
Family Care Medical Group                                               

VBP Group:  Summerwood Peds


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.

Resources

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


 

WINTER 2025 PROVIDER BULLETIN


  • Social Care Networks Program (SCN) Now Live
  • Fidelis Care Provider Portal and Availity Essentials Transition
  • Encourage Patients to Get Screened for Hepatitis C
  • Family Planning and Reproductive Healthcare
  • The Importance of Domestic Violence Screening

 

 

Provider Quality News


Mental Health Awareness Month: Honoring Behavioral Health Professionals
5/20/2024 • Posted by Fidelis Care in In The Community

In observance of Mental Health Awareness Month, Fidelis Care salutes our team of behavioral health professionals who work tirelessly to help our members receive the care and services they need. This week, we highlight some of these counselors, social workers, and administrators who have dedicated their careers to assisting others.

 

Ashlei Allen, Care Manager

I knew at an early age that I would go into behavioral health because I recognized how helping others positively impacted me. Whether this was talking through a problem with a friend or mediating a conflict within a group, I always found joy when people felt better. I joined the Fidelis Care team in 2022 as a Care Manager. In this role, I assist members with getting connected to providers and programs that can improve their overall health. I find meaning in helping members identify solutions to their health concerns, in addition to informing them of resources that could be beneficial to them.


Jon Anderson, LMSW, Manager - Clinical

Using my clinical skills and experience, I can positively impact the lives of our members with mental illness and substance use disorders. I joined Fidelis Care in 2015 following a 15-year career spent providing direct care to individuals in the community. Fidelis Care leaders encouraged me to access my creativity and compassion to improve health outcomes for our members. Working on a team dedicated to improving lives, one member at a time, has been the highlight of my professional career. 


Jennie Calvaneso, LMHC, Clinician Specialist

I am currently the Clinician Specialist in the Utilization Management Department with previous behavioral health experience at Fidelis Care and with other mental health experience in outpatient clinics and crisis intervention. I chose to become a Licensed Mental Health Counselor because I saw firsthand what untreated and unsupported mental health issues can do to a person. In my transition from direct care to Fidelis Care, I have enjoyed expanding my knowledge base while still being able to help address mental health issues for people in need.


Kristen Esopi, LMSW, Care Manager - Social Work

As a Care Manager on the Transitions of Care team, I help members who were recently discharged from a behavioral health unit or substance use disorder treatment program. The days immediately following a hospitalization can be a very vulnerable time. I am proud to personally provide support to these members with the goal of furthering their recovery. I am dedicated to making a difference in the lives of our members. My daily interactions with them provide countless opportunities to assist and engage.


Melissa Kenna, Utilization Review Clinician

I chose to go into behavioral healthcare after working in psychiatric hospitals as a Certified Therapeutic Recreation Specialist. I gained experience leading groups, completing clinical assessments, and working with individuals on their treatment plan goals. My work with these individuals led me to want to help more. Fidelis Care has given me the opportunity to provide quality care by working directly with providers to assure proper treatment for our members. This leaves me feeling humbled and knowing that I can make a difference.


Jennifer Liang, LCSW, Manager - Clinical

I started within the realm of social services as a case manager at a domestic violence agency in 2005. My role was to ensure the survivors were connected to services and benefits to start their healing journey. That experience led to my decision to pursue a higher degree in clinical social work. Any small or large change provides me with a sense of gratification and motivates me each day. In my current role as manager of the Fidelis Care pediatric program, I am entrusted with the pivotal responsibility and privilege of providing comprehensive oversight to a specialized care management team.


Thomas Michaels, LMHC, Medical Management Auditor

I wanted to become a social worker to assist people in meeting their everyday needs. As a Medical Management Auditor within the Behavioral Health Department, I have the chance to help others. I provide care management analysis to people leaders, while working within an interdisciplinary framework to help enhance the lives of our members.  Fidelis Care provides a working environment that promotes member-centered care, while also providing a supportive, professional learning environment to continue my growth as a social worker.


Damanie Outar, LMSW, Care Manager - Social Work

I decided to pursue a career as a social worker to help others strive for a better life, overcome their challenges, and make a positive impact on our community. As a Fidelis Care Social Work Care Manager, I provide planning, coordination, and authorization of services to our members. I complete health assessments as well as reviews of environmental and psychosocial status of members. I also identify risks for members and recommend appropriate interventions. I find being a social worker is a fulfilling career because I get to do what I love every day. 


Carolina Rosado, Authorization Specialist

I started with Fidelis Care in November 2020 as a behavioral health call center representative, working with members and providers on mental health concerns. I was later trained on how to identify members in crisis and send them to a crisis hotline. I then moved to the team that handles authorization requests and quickly became team lead. My work at Fidelis Care makes a difference in the lives of our members. Raising awareness of mental health issues reduces the stigma and discrimination associated with mental illness and seeking treatment. There is no overall health without mental health.


Emilie Saccone, LMSW, Care Manager - Social Work

Behavioral health is such an important aspect of overall health because our physical and mental health are so closely linked to each other. As a Care Manager at Fidelis Care for the past two years, I experience the ups and downs with our members as we navigate their mental health needs together. It is a great accomplishment any time I get to see a member connected to the supportive services they need to contribute to their overall wellness.


Maggie Villafranca, LMSW, Care Manager - Social Work

I have enjoyed volunteering and helping my community since high school and knew early on giving back to my community was going to be my professional focus. I graduated with a master’s degree from NYU’s Silver School of Social Work where the curriculum was focused on working with individuals, groups, and families. Working at Fidelis Care has allowed me to continue that path in assisting members by navigating the complexities of their psychosocial needs while understanding the importance of their overall health.


Vickie Zemla, LCSW, CASAC II, Manager - Clinical Business Monitoring

As a licensed clinical social worker and credentialed alcoholism and substance abuse counselor, supporting individuals to achieve their goals and establishing continuity of care has always been my passion. In my clinical career, I work with individuals in crisis and forensic mental health. The most rewarding part of my job is seeing how our organization can quickly adapt and change our approaches to ensure we are providing the best person-centered, quality care management.