Introduction to NCQA Credentialing Standards
Duration: 10 hours
Introduction to NCQA Credentialing Standards
This OnDemand course provides an in-depth explanation of NCQA's credentialing standards. Faculty will walk participants through a detailed explanation of each Credentialing standard and lead participants through scenarios that are designed to mimic real-life credentialing scenarios.
Note: This webinar recording will review NCQA's Credentialing standards.
This OnDemand course is geared towards individuals with one year of experience, or less; collecting, reporting and acting upon credentialing data; or those who need a refresher, including:
- Credentialing Specialists/Coordinators/Managers/Directors
- Provider Relations Specialists/Managers
- Quality Assurance Managers/Directors
- Quality Improvement Managers/Directors
- Regulatory Specialists/Managers/Directors
- Explain the NCQA Credentialing standards.
- Identify appropriate credentialing and recredentialing documentation and operational procedures required to comply with NCQA Accreditation standards.
- Describe the NCQA Credentialing standards to assist health organizations in the credentialing process.
- Discuss and identify the credentialing differences between Health Plan, Managed Behavioral Health Organizations, Credentialing Verification Office and Credentialing Accreditation.
Cindy Allen-Fedor, RN, MPA, CPHQ, ACM
Cindy Allen-Fedor has held a variety of positions in healthcare organizations. She served as an Executive Vice-President for an integrated health system Her areas of responsibility included Quality Improvement, Case Management, Disease Management, Patient Safety, Credentialing, Accreditation and Regulatory Compliance. Cindy is a registered nurse and NCQA Surveyor. She is also a Certified Professional in Healthcare Quality (CPHQ) and an Accredited Case Manager (ACM).
Cindy became an independent consultant in 2012. Drawing on her extensive experience as a nurse and NCQA Surveyor, she provides a wide range of consulting services. She has successfully guided many organizations through preparation and achievement of NCQA-Accreditation and Certification. Cindy’s areas of expertise include knowledge and experience assessing, developing and implementing: Utilization Management, Case Management, Population Health, Quality Improvement, Credentialing, Accreditation and Regulatory Compliance.
Veronica Locke, MHSA
Veronica Locke is a consultant for The Mihalik Group, providing healthcare-related consulting services. Her areas of expertise include quality assessment and improvement; Credentialing; Delegation; Disease Management Accreditation/Certification; Population Health Management; Multicultural Health Care.
Veronica is the former Senior Manager of Accreditation Policy for the National Committee for Quality Assurance. She was actively involved in the development and maintenance of the standards and guidelines of NCQA's Accreditation and Certification programs, specifically Health Plan, Disease Management and Multicultural Health Care Distinction programs.
As a member of the Policy team, one of her major responsibilities was to serve as a content champion when providing policy clarifications and trainings internally and externally.
She received her Bachelor of Science Degree in Public Health from the University of Maryland. College Park and her Master of Health Systems Administration Degree from Georgetown University in Washington, DC.
In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC) to provide Interprofessional Continuing Education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
This educational activity is approved for: 8.0 AMA PRA Category 1 CreditTM and ACPE.
This educational activity is approved for 8.0 nursing contact hours.*
The assigned universal program number: JA0004597-0000-20-017-H04-P. Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit.
* Please note – You must attend the entire program to be eligible for total number of contact hours.
ATTENTION: Effective February 1, 2022, this on-demand (enduring material) activity no longer offers credits for the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), or the Association of Social Work Boards (ASWB). Only applicable professionals who fully completed this on-demand activity prior to February 1, 2022, are eligible for AAPA, APA, or ASWB credits. No other CEUs are impacted by this change.
- 8.00 ACPE
- 8.00 AMA PRA Category 1 Credit™
- 8.00 ANCC
- 8.00 IPCE
- 1.00 Participation
Access to this content will expire on August 31, 2022. Access will not be extended beyond that date.
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