Introduction to NCQA’s Credentialing Standards 101 - ODM

This training was presented to the Ohio Department of Medicaid and was designed for the new participant preparing for NCQA’s Credentialing Accreditation Program. An overview of NCQA’s mission and vision, survey process and policies and procedures were reviewed, focusing on an in-depth explanation of NCQA’s Credentialing Standards. Discussion on Delegation and the credentialing workflow for providers and payors was included. This one day educational webinar was presented by Veronica Locke included a live question-and-answer session following the presentation. Participants are encouraged to review the Credentialing Standards and Guidelines to enhance the learning experience.

This training was recorded on November 1, 2019.

Learning Objectives

  • Describe NCQA’s Mission and the Survey Process.
  • Explain the applicable Credentialing Standards & Guidelines in Health Plan Accreditation.
  • Discuss what policies and procedures of Credentialing entail.
  • Define the credentialing workflow for providers and payors.
  • Discuss the delegation of credentialing.
Course summary
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Veronica C. 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.

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