Provider Network Accreditation: Know and Grow
Provider Network Accreditation: Know and Grow
This 90-minute program is designed for the new and seasoned participants preparing for the NCQA Credentialing Certification/Accreditation and Provider Network (PN) Accreditation. It provides an overview of the Credentialing products and the NCQA Accreditation process. Additionally, the PN Accreditation requirements will be reviewed, focusing on preparing for a survey and learning how to read a PN Accreditation standard. This educational webinar series will be presented by Veronica Locke & Sheronica Barcliff and includes a live question-and-answer session following each presentation. Participants are encouraged to purchase the new Utilization Management and Credentialing Standards to enhance the learning experience.
This on-line program is geared towards individuals with one year or less of experience in UM & CR Accreditation as well as seasoned individuals who need a refresher on how to best prepare for NCQA Credentialing Accreditation. This beginner level program is especially beneficial for those involved in collecting, reporting, or acting upon Credentialing results. Additionally, those participating and carrying out UM activities (including UM criteria and decision-making) and PN activities (including network management activities and services) will benefit from this on-line program.
- Credentialing Coordinators
- Credentialing Supervisors
- Quality Assurance/Quality Improvement Directors
- Quality Managers
- Medical Directors
- Operations Directors
- Information Systems Directors
- Medical/Specialty Groups
- Staff who work on Certification Products
- Provider Networks
- Network Management Organizations
At the conclusion of the module, participants will have the knowledge they need to:
- Discuss the different nuances between UM and CR Accreditation, CVO Certification, and PN Accreditation.
- High level understanding of the UM, CR, and PN Accreditation standards.
- Describe the core and must pass elements required for Accreditation.
- Understand how to read a NCQA standard.
- Understand NCQA’s Survey Process.
- Prepare documentation per NCQA Guidelines.
Sheronica Barcliff, BS, MSHA
Ms. Barcliff is the Founder and CEO of The Barcliff Group LLC, a health care quality and wellness organization offering a suite of services and products.
Previously, Ms. Barcliff was an Accreditation Manager with the Accreditation Operations of the National Committee for Quality Assurance (NCQA). She was responsible for coordinating and conducting accreditation and certification surveys for healthcare organizations.
Prior to joining Accreditation Operations, Ms. Barcliff held the position of Associate Manager of Quality, Accreditation, and Credentialing in the Medical Management Department at Virginia Premier Health Plan. She was responsible for assisting all three operational areas in coordinating and leading departmental processes as well as leading quality work teams and projects for impacted departments. She was also responsible for ensuring on-going compliance to internal, accreditation and/or regulatory standards through data entry, collection, tracking, trending, monitoring, and analysis.
Prior to joining Quality Operations, Ms. Barcliff held the position of Quality Implementation Specialist & Interim Credentialing Manager at Virginia Premier Health Plan. In those positions, she was responsible for managing and overseeing all delegated and non-delegated credentialing activities. She was responsible for leading Medicaid and Medicare Deeming regulatory accreditation work teams company-wide to ensure on-going compliance through departmental audits and organizational education orientations related to standards of compliance.
Ms. Barcliff received her B.S. in Sports Medicine from the University of Virginia in Charlottesville, VA and received a Master’s of Science in Health Administration from Virginia Commonwealth University in Richmond, Virginia.
Veronica Locke, MHSA
Veronica C. Locke is a Manager of Policy, Accreditation for the National Committee for Quality Assurance (NCQA). She is actively involved in the development and maintenance of the standards and guidelines of NCQA's Accreditation and Certification programs, specifically Health Plan (HP), Disease Management (DM) and Multicultural Health Care (MHC). As a member of the Policy team, one of her major responsibilities is to serve as a content champion when providing policy clarifications and trainings internally and externally. Veronica also manages NCQA's Accreditation and Certification Users Group (ACUG), which is an interactive learning community for healthcare organizations to communicate with each other and staff members to learn best practices and help shape NCQA's products and services.
Ms. Locke received her Bachelor of Science in Public Health from the University of Maryland, College Park and received her Master of Health Systems Administration (MHSA) from Georgetown University.
In support of improving patient care, the National Committee for Quality Assurance (NCQA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
NCQA designates this live educational activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This educational activity is approved for 1.5 nursing education contact hours.*
* Please note – You must attend the entire program to be eligible for total number of contact hours.
- 1.50 AMA PRA Category 1 Credit™
- 1.50 ANCC
- 1.00 Participation