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SUMMARY:Network Management 301: Advanced - Lessons from NCQA Surveys
DESCRIPTION:About this Learning Activity\nNetwork Management 301: 
 Lessons from NCQA Surveys\nThrough this learning activity\, 
 health plan professionals and their partners are guided 
 through critical practices for network management. More 
 specifically\, this surveyor-led online course equips 
 professionals with insight into low performing standards 
 specific to Network Management. The course includes examples 
 and lessons learned to help participants define\, plan\, and 
 achieve excellence in network management. By completing this 
 course\, professionals will have clear direction on where to 
 focus their operational efforts.\n\nKey 
 Topics:\n\n\nAvailability of Practitioners\nAssessment of 
 Network Adequacy\n\nWhat You Will Learn\n\nIdentify the most 
 frequent pitfalls observed by NCQA surveyors\nImplement 
 practices that align with target outcomes\nDescribe 
 documentation that demonstrates compliance to standard 
 requirements\nRecognize opportunities for policy\, procedure\, 
 or documentation adjustments.\n\n                            
                                                              
                                                              
       \n\nWho Should Attend\n\nClinicians\, directors\, 
 managers\, specialists\, and coordinators who contribute to 
 provide network operations\nConsultants\, contractors\, 
 delegates\, and vendors of health plans\nProfessionals in 
 compliance or risk management\nProfessionals in quality 
 assurance/improvement or performance 
 measurement\n\nFaculty\n\nAlbert “Irv” Koehler\, RN\, 
 MBA\nIrv Koehler is a health care quality consultant for the 
 Koehler Quality Group\, LLC. In this position\, he is an NCQA 
 administrative surveyor and provides consulting services to 
 organizations evaluating and preparing for NCQA 
 Accreditation/ Certification projects\, risk adjustment 
 validation for managed care organizations\, education on 
 quality improvement practices and outcome measure 
 development and tracking. Mr. Koehler is also a registered 
 nurse with active licensure in Florida and Tennessee\, and 
 certification in quality and medical coding. Previously\, he 
 was a quality improvement professional at AmeriHealth 
 Caritas and BlueCross BlueShield of Tennessee.\n\nMr. 
 Koehler has an MBA from the Florida Institute of Technology\, 
 a BS in Nursing from Florida Southern College\, a BA in 
 Psychology and an ADN from Purdue University.\n\nContinuing 
 Education\nThis live course grants 1.0 required Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.\n\nThis is a non AMA PRA Category 1 Credit™\, ANA 
 CNE\, ACPE activity.\n\n* Please note – You must attend the 
 entire program to be eligible for total number of contact 
 hours.\n\nDisclosure of Relevant Financial 
 Relationships\nThe National Committee for Quality Assurance 
 (NCQA) endorses the Standards of the Accreditation Council 
 for Continuing Medical Education which specify that sponsors 
 of continuing medical education activities and presenters at 
 and planners for these activities disclose any relevant 
 financial relationships either party might have with 
 commercial companies whose products or services are 
 discussed in educational presentations.\n\nFor sponsors\, 
 relevant financial relationships include large research 
 grants\, institutional agreements for joint initiatives\, 
 substantial gifts\, or other relationships that benefit the 
 institution.  For presenters or planning committee members\, 
 relevant financial relationships include the receipt of 
 research grants from a commercial company\, consultancies\, 
 honoraria\, travel\, or other benefits\, or having a 
 self-managed equity interest in a company\; or having an 
 immediate family member or partner with such a 
 relationship.\n\nDisclosure of a relationship is not 
 intended to suggest or condone bias in any presentation but 
 is made to provide participants with information that might 
 be of potential importance to their evaluation of a 
 presentation.\n\nRelevant financial relationships exist with 
 the following 
 companies/organizations:\n\nFaculty:\n\n\nAlbert Koehler: 
 None\n\nAdditional Planning Committee Members:\n\nVince 
 Pereira: None \nJulie Pung: None \nTandeece Tubolino: 
 None\n\n \n\nThis program was developed in part by NCQA 
 staff.\n\nThis program received no commercial support.\n
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