CAQH Establishes a Provider Advisory Council to Expand Provider Engagement and Advance Healthcare Data Solutions

The CAQH Provider Advisory Council (PAC) unites clinical leaders to enhance industry-leading provider data solutions and solve systemic provider data challenges impacting the U.S. healthcare system.

WASHINGTON, March 17, 2025 /PRNewswire/ — For 25 years, CAQH has eliminated billions of dollars of healthcare waste and inefficiency, earning the industry’s trust to manage the majority of the provider data in the U.S. As the leader in provider data management, CAQH ensures healthcare organizations have access to the most comprehensive, up-to-date information to meet provider credentialing and directory requirements. To ensure continued support of provider and customer needs, CAQH has launched the Provider Advisory Council (PAC). The council will shape the next generation of provider data management solutions and ensure provider experience is at the forefront of the data solutions transformation. The PAC will bring real-world provider perspectives to the table and inform the healthcare operating rules and standards decisions led by the CAQH’s CORE & Insights team.

“CAQH sits at the intersection of health plans, providers, and technology vendors, ensuring the data powering our industry is precise and actionable,” said Brian D. Pieninck, CAQH Board Chair and President and CEO of CareFirst BlueCross BlueShield. “By integrating provider insights, we bolster CAQH’s position as the gateway for enrollment, credentialing, and directory data management. With direct input from providers, our solutions will establish new industry benchmarks, benefiting providers, plans, and ultimately, the patients we all serve.”

Sarah Ahmad, MBA, CEO of CAQH, and Brad Sutton, MD, Chief Medical Officer at AF Solutions, Boston Scientific, will co-chair the PAC, alongside a distinguished group of healthcare leaders:

• Nikole Benders-Hadi, MD – Chief Medical Officer, Talkspace
• Roy Beveridge, MD – Managing Director, Avalere Health
• Gigi Girard, MD – Executive Medical Director of Women’s Services, Norton Healthcare
• Steven Goldberg, MD – Chief Medical Officer, HealthTrackRx
• David Guggenheim, PsyD – National Director of Psychotherapy, Talkiatry
• Mirini Kim, DNP – Chief Nursing Officer, PocketRN
• Susan Manzi, MD – Chair of the Medicine Institute, Allegheny Health Network

As the industry’s trusted steward of provider and member data, CAQH is committed to driving provider-led innovation. Reinforcing this focus, CAQH has appointed Katie Davis, NP, as Vice President of Provider Relations, to ensure patient care remains at the center of its initiatives.

“Our founding purpose – to reduce administrative burden across the healthcare ecosystem – continues to guide us,” said Sarah Ahmad, CEO of CAQH. “By engaging provider leaders, we can develop the right provider data solutions that meet the complex challenges of modern healthcare delivery and solve provider data problems that the industry has faced for decades. As the backbone of U.S. provider data management, CAQH supports provider enrollment, credentialing, and directory management at scale for 830 health plans and care delivery systems. The PAC will explore new ways to leverage CAQH’s expansive provider data and directory capabilities so we may improve patient access to quality care.”

For more information about the CAQH Provider Advisory Council, its mission, and its members, visit the PAC page. 

About CAQH

CAQH is the leader in healthcare data, enabling health plans, providers, and stakeholders to seamlessly exchange and manage the most trusted provider and member data in the U.S. By connecting over 1,000 health plans and other entities with 4.8 million provider records and data on more than 235 million members, CAQH streamlines operations and improves data accuracy. Through industry-leading solutions, federally mandated CORE Operating Rules, and actionable insights, CAQH makes healthcare work better—so patients can access the care they need, when they need it. Learn more at CAQH.org

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SOURCE CAQH