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SUMMARY:Delegation 301: Advanced - Oversight for Utilization Management
DESCRIPTION:About this Learning Activity\nDelegation 301: Advanced - 
 Oversight for Utilization Management\nThroughout the course\, 
 learners engage with realistic case studies\, examine sample 
 files\, and apply oversight techniques while receiving 
 practical guidance from seasoned subject‑matter experts. 
 The experience focuses on building a strong oversight 
 structure that supports audit readiness and aligns with 
 regulatory and accreditation expectations. Participants walk 
 away with actionable tools and insights they can immediately 
 put to work within their organizations. Moreover\, this 
 session complements the NCQA toolkit for NCQA Delegation: 
 https://www.ncqa.org/making-the-most-of-your-delegation-prac 
 tical-guidance-for-health-plans/\n\nLearning 
 Materials\n\n\nRecording of live sessions\nPresentation 
 slides\nApplied scenarios\nLive Q&A (during live session 
 only)\n\nBenefits\n\n\nPerspectives of an NCQA 
 Surveyor\nPractical applications                             
        \n\nWhat You Will Learn\nTopics\n\n\nUse cases in 
 Utilization Management\nEffective Collaboration\nRecurring 
 Audits\nDelegated Functions\nPerforming Monitoring and 
 Reporting\n\nLearning Objectives\n\nBy participating within 
 this learning activity\, learners will:\n\n\nAnalyze the 
 organization’s retained accountability for utilization 
 management within delegated arrangements.\nEvaluate the 
 effectiveness of delegation oversight structures—such as 
 monitoring\, reporting\, audits\, and corrective 
 action.\nRefine delegation oversight procedures that 
 strengthen organizational accountability\, mitigate risk\, and 
 ensure consistent utilization management 
 outcomes.\n\nLearning Outcomes\n\nBy completing this 
 learning\, learners will be equipped to:\n\n\nAlign 
 reciprocal expectations to achieve target 
 outcomes.\nValidate the effectiveness of oversight practices 
 for delegated functions.\nOptimize oversight communications 
 effectively to internal leadership and delegated 
 partners\n\nWho Should Attend\n\nUtilization Management 
 leaders\, clinicians\, directors\, managers\, specialists\, and 
 coordinators.\nPartners\, consultants\, contractors\, 
 delegates\, and vendors who support utilization management 
 teams.\nProfessionals in quality assurance/improvement or 
 performance measurement.\n\nFaculty\nKimberly Petit\, MBA  
 \n\nKim began consulting in 2017\, drawing from her numerous 
 and varied accreditation experiences\, she has successfully 
 guided many organizations through the preparation and 
 achievement of NCQA-Accreditation and Certification. Prior 
 to consulting\, Kim was the Sr. Director\, Head of QM Program\, 
 Accreditation\, Credentialing and Delegated Credentialing for 
 all Commercial\, Medicare and Exchange product lines across 
 Aetna\, Coventry and Joint Ventures. In this role\, Kim had 
 accountability for setting strategy and overall execution of 
 the National Quality Program to meet regulatory requirements 
 and maintain NCQA accreditation. \n\nKim has her MBA from 
 the Kellstadt Graduate School of Business at DePaul 
 University and her BS from the University of Illinois\, 
 Champaign-Urbana. Kim serves as a surveyor for the National 
 Committee for Quality Assurance since 2009. She also served 
 an adjunct professor at the Kellstadt Graduate School of 
 Business\, teaching MGT 510: Health Technology\, Informatics & 
 Quality\, a Health Insurance Industry Perspective. Kim lives 
 west of Chicago on an organic farm with her husband and son. 
 \n\nIn her spare time Kim is an avid tennis 
 player.\n\nContinuing Education\nThis course grants 1 Other 
 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.\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:\nKimberly Petit: None\n\nAdditional Planning 
 Committee Members:\n\n\nJulie Pung: None\n\nVince Pereira: 
 None\n\nThis program was developed in part by NCQA 
 staff.\n\nThis program received no commercial support.\n
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