Client Overview

A federally qualified Community Health Center (CHC) system with 18 clinics across two states, serving approximately 145,000 unique patients annually. The centers deliver comprehensive primary care, pediatrics, women’s health, behavioral health, dental, and mobile services. With a payer mix heavily skewed toward Medicaid and uninsured populations, the CHC is bound by Uniform Data System (UDS) and HRSA compliance requirements.

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Business Challenges

The CHC faced a growing access crisis driven by staffing shortages and operational inefficiencies:

1. Appointment backlogs: 21–46 days for primary care and over 60 days for behavioral health.

2. High turnover: 22% provider and 36% medical assistant/front-desk churn annually.

3. Compliance risks: Gaps in UDS metrics and missed HRSA continuity-of-care targets.

4. Patient experience decline: Lower CAHPS satisfaction and burnout indicators among staff.

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Engagement Objectives

• Reduce median new-patient wait time to ≤14 days within 120 days.

• Improve show rates by 8–10% across service lines.

• Decrease time-to-start for new hires and stabilize agency spend.

• Maintain strict HRSA, Joint Commission, and patient experience compliance.

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Constraints and Risks

• Tight operating margins with little tolerance for idle capacity.

• Limited rural talent pools.

• Credentialing bottlenecks averaging 42 days.

• Unionized workforce and language access mandates (Spanish, Vietnamese).

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Pulivarthi Group’s Role

Pulivarthi Group deployed a turnkey workforce solution covering demand forecasting, sourcing, screening, credentialing, onboarding, and retention—aligned with CHC’s mission-driven culture and regulatory requirements. The engagement focused on outcomes, not fixed-cost commitments, with performance tracked via KPIs and SLAs.

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Discovery Insights (Weeks 0–2)

• 35% of missed appointments clustered in three clinics with transportation barriers.

• MA and PSR turnover linked to rigid schedules and lack of cross-training.

• Credentialing delays were the leading cause of provider onboarding failure.

• Behavioral health no-show rates reached 19% due to insufficient evening hours.

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Solution Blueprint

A. Capacity & Workforce Mix

Combined full-time hires, long-term locums, and bilingual float pools to balance continuity and surge needs.

B. Talent Pipeline

Community-based sourcing targeting clinicians with NHSC or residency ties; referral bonuses and a refreshed employer-branding microsite.

C. Credentialing Process

“Preflight” documentation checklist with parallel processing and weekly readiness huddles.

D. Operations Optimization

Cross-training for MA/PSR roles, micro-scheduling with 15-minute templates, and same-day appointment blocks.

E. Retention & Culture

Mentorship pairings, quarterly stay interviews, and recognition cadences to reduce early attrition.

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Key Roles Delivered (First 90 Days)

• 6 Family Medicine MD/DO

• 4 FNP/PA (Primary Care)

• 3 Behavioral Health Clinicians (LCSW/LMFT)

• 1 Pediatric Dentist

• 9 Medical Assistants

• 7 Patient Services Representatives

• 2 Care Coordinators

• 1 Clinic Operations Manager

54% of all hires were bilingual (Spanish or Vietnamese); 72% had prior CHC or underserved-community experience.

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Implementation Timeline

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Compliance and Quality Controls

All hires completed OIG/GSA, NPDB, immunization, and background checks. Documentation followed Joint Commission standards, with file audits mapped to UDS workforce impact measures.

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Scheduling and Access Redesign

• 10–15% same-day access reserved on provider templates.

• Behavioral health evening clinics three times weekly.

• Pediatric “back-to-school” surge plans.

• Weekend mobile-unit staffing using float pools.

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Technology and Analytics

• Applicant tracking integrated with structured competency scorecards.

• Credentialing Kanban boards tracking SLA performance.

• Weekly KPI dashboards on fill rate, retention, wait times, and patient access.

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Training and Enablement

Cross-training expanded MA skill scope (e.g., phlebotomy), while PSRs received scripting for benefits verification and warm hand-offs. Supervisors were coached on interview calibration and stay-interview protocols.

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Measured Outcomes (120 Days)

• Wait time reduction: 28.7 → 12.9 days (-55%).

• Behavioral health access: 62 → 24 days (-61%).

• Show rate: +9.4 percentage points (BH +12.1 pp).

• Vacancy aging: -41%.

• Overtime hours: -23%.

• CAHPS “Access to Care” score: +6.8 points.

• A1c follow-up completion: +7.2 points in diabetic registries.

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Financial and Operational Impact

• Time-to-start reduced by 37% through credentialing acceleration.

• Agency spend volatility decreased by 32%.

• Recovered visits: ~11,400 additional encounters annually through improved show rates.

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Retention Outcomes (6 Months)

• Provider retention: 93%.

• MA/PSR churn: reduced from 36% → 22% following flexible scheduling and mentorship.

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Patient-Experience Highlights

• Weekend mobile units increased well-child immunizations by 14% in target ZIPs.

• Bilingual front-desk hires cut registration errors by 18% and improved first-call resolution by 11%.

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Sustainability and Handoff

Pulivarthi Group delivered a replicable Workforce Playbook, including interview guides, credentialing checklists, and surge staffing calendars. The CHC adopted a quarterly workforce planning cadence and internal float pool governance model.

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Client Testimonial

“Access moved from weeks to days without overwhelming our teams. The staggered start plan and bilingual hires directly improved patient trust and follow-through.”
— Chief Clinical Officer, CHC System

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What Drove Success

• Mission-aligned storytelling that attracted purpose-driven candidates.

• Credentialing preflight that minimized administrative lag.

• Data-driven scheduling to align provider hours with patient demand.

• Manager training that fostered early retention through connection and recognition.

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Replicable Playbook

1. Model demand per clinic by backlog and show rate.

2. Secure a bilingual float pool before onboarding FTEs.

3. Preflight all credentialing packets and hold weekly readiness huddles.

4. Stagger starts to maintain continuity of care.

5. Launch mentorship and stay interviews at day 30.

6. Publish KPI dashboards weekly and adjust templates bi-weekly.

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KPIs and SLAs Tracked

• Time-to-slate | Time-to-start | Credentialing cycle time

• Fill rate | Vacancy aging | 90-day retention

• Median days to 3rd-next-available | Show rate | Same-day access utilization

• CAHPS access composite | Clinical quality metrics (A1c, well-child visits)

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Next-Phase Roadmap

• Expand Integrated Behavioral Health at six additional clinics.

• Introduce dental hygiene outreach days for school-based backlogs.

• Pilot tele-OB consult blocks for remote rural sites.

• Build an MA career ladder program with tuition assistance to reduce churn below 18%.

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About Pulivarthi Group

Pulivarthi Group LLC is a leading global staffing provider specializing in healthcare, financial services, IT, government, and dental sectors across the U.S., Canada, and Mexico. The firm delivers custom workforce solutions that balance cost efficiency, compliance, and patient-care excellence.