Processes
Develop and manage the network
How develop and manage the network are reshaped as AGI capability advances.
ProcessesDevelop and manage the network
Business-as-Code
Read as an executable program — the work decomposed into Code, Generative, Agentic, and Human.
Develop and manage the network sits inside a larger value-flow — 1 parent structure it composes into. The hierarchy is grounding, not the story: it tells you which aggregate exposure Develop and manage the network inherits.
Where Develop and manage the network sits
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How the work flows
Trigger: A gap in provider coverage is identified, a geographic expansion is initiated, or a periodic network adequacy review occurs.
- Identify geographic and specialty coverage needs based on member demographics
- Recruit target healthcare providers and facilities
- Conduct provider credentialing and primary source verification
- Negotiate reimbursement rates and execute provider contracts
- Load provider demographic and contract data into core systems
- Audit provider directories for accuracy and accessibility
- Monitor network adequacy and manage ongoing provider relationships
Outcome: A compliant, contracted network of healthcare providers is actively maintained and integrated into member directories and claims systems.
Measured by
Network Adequacy RatioCredentialing Cycle TimeProvider Directory Accuracy RateProvider Turnover Rate