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Managed Care

Our role in Managed Care is to enroll providers and develop, analyze, negotiate and manage payer contracts. We facilitate contract negotiations between third party payers and RowanSOM University Doctors Faculty Practice Plan (RowanSOM UD FPP) by conducting legal and financial analyses to determine the feasibility of each potential managed care contract.

If you have further questions, please feel free to email us: SOM_Managedcare@rowan.edu 

Our Services

Our department actively maintains the participation status for clinical providers with the third party payers and health insurance carriers by maintaining up to date information about the health care professionals employed by RowanSOM UD FPP. This process involves tracking the practitioner’s credentials, service locations, office hours and healthcare services that are rendered at each location. Our staff works closely with the third party payers to ensure that the practitioners information is displayed correctly in the health insurers website directory and claims systems, so that patients will have seamless access to the clinical providers at RowanSOM.

If you have further questions, please feel free to contact:

Monica Roig, Program Coordinator - Credentialing
856-566-6706

Latasha Christian, Program Specialist - Credentialing
856-566-6413

Quick Reference

The following is a list of sources for physicians and practitioners to reference when they need to apply or renew necessary credentials to practice medicine in New Jersey. Please make sure to comply with all requirements of the licensing board deadlines for new and renewing applications and documents. New Jersey has many professionals who require licensure so processing times vary by issuing agencies.

At each renewal period, the Managed Care office will send a reminder to the Department Administrator to collect the necessary copies of the documents required. Please make sure to sign all applicable licenses/certificates before forwarding to the Managed Care Department. These documents are requested and required for RowanSOM internal credentialing process and to activate/maintain participation with RowanSOM University Doctors FPP contracted health insurances.

Please refer to your RowanSOM UD FPP Application for a complete list of required documents. A few required documents:

CDS Certificate issued by:
Department of Law & Public Health – Division of Consumer Affairs
Issues the certificate necessary for prescribing controlled substances in New Jersey.
See specifically: New Jersey CDS Registration Processing Frequently Asked Questions (FAQ's)

DEA License issued by:
US Dept of Justice, Drug Enforcement Administration - Office of Diversion Control
Registration is required to write prescriptions in the United States

ECFMG Certificate issued by:
Education Commission for Foreign Medical Graduates
Certification administered by ECFMG is required for all physicians who attended medical school abroad. Physicians trained in Canada or Puerto Rico do not need an ECFMG certificate.

NJ Medical License issued by:
The State Board of Medical Examiners
This website contains information about how to obtain a NJ Medical license and renewals.

NPI issued by:
National Plan and Provider Enumeration System
You may look up individual providers NPI and apply for an NPI number on-line through this web portal.