Provider services

Our Provider Services Department serves as a liaison between the Health Plan and the provider community. 

We will work with you in:

  • Conducting onsite provider training
  • Helping identify and resolve problems
  • Conducting provider office visits
  • Setting up accessibility audits

We can help you

Our Provider Services Representatives are available by phone at 1-855-232-3596 or email to support all providers. Some of the everyday actions we take to help you include:

  • Notifying you of an address change
  • Keeping track of member updates
  • Locating forms
  • Reviewing member information
  • Checking member eligibility
  • Finding a participating provider or specialist
  • Submitting a prior authorization
  • Reviewing or searching the Preferred Drug List/formulary
  • Notifying the plan of a provider termination
  • Notifying the plan of changes to your practice
  • Advising a Tax ID or National Provider Identification (NPI) Number change
  • Obtaining a secure web portal or member care Login ID
  • Reviewing claims or remittance advice

Our Provider Services Department supports multiple functions in network development and contracting. This includes evaluation of the provider network, and compliance with regulatory network capacity standards. Our staff is responsible for the creation and development of provider communication materials, including the Provider Manual, periodic provider newsletters, bulletins, fax/email blasts, website notices and the provider orientation kit. 

Contact Our Provider Relations Staff

Shanise Williams

Manager, Provider Relations

Office: 609-282-8226

Fax: 860-607-7768

 

Michelle Rubino

Strategic Alliance Account Manager

Office: 609.282.8204

Fax: 860-60-8285

E-mail: RubinoM@aetna.com

Territory: IPA, FQHC, Urgent Care, AvoCare, Reliance IPA

 

Janice Poinsett

Provider Relations Liaison

Cell:  609-613-8022      

Fax:  860-900-7315

E-mail:  PoinsettJ@aetna.com

Territory: Middlesex, Burlington, Camden, Gloucester, Atlantic, Salem, Cumberland, Ocean and Cape May

 

Tanya Williams

Provider Relations Liaison

E-mail: WilliamsT30@aetna.com  

Territory: Passaic, Bergen, Morris, Essex, Sussex, Warren

 

Quiche Jones

Provider Relations Liaison

Office: 609-613-8012

E-mail: JonesQ2aetna.com         

Territory: Hudson, Union, Somerset, Mercer, Monmouth, Hunterdon