Utilization Management Accreditation

About this Webinar Training

NCQA Updates for Utilization Management Accreditation

This is a comprehensive explanation of updates and changes to Utilization Management Accreditation. NCQA surveyors and staff guide learners through requirement updates and their implications.

Early Bird Rate: $595 until August 1, 2025. Use CODE: NCQA-UM-08

What You Will Learn

Course Topics

• Quality Improvement for Utilization Management

• Collaboration With Delegates

• Privacy and Confidentiality

• Timeliness of Decisions

Learning Objectives

Throughout the course, learners will:

• Discuss the foundational attributes of a case management program.

• Describe case management activities that demonstrate compliance with NCQA requirements.

• Define practices for ensuring effective and timely communication with members.

• Recognize tactics for optimizing collaboration between health plans and UM delegates.

• Evaluate case management scenarios to identify lessons learned.

Course Outcomes

After completing this course, learners will be able to:

• Develop delegate agreements that demonstrate value to delegating entities.

• Evaluate the effectiveness of their current case management program.

• Recognize the changes necessary to improve a case management program.

Resources Included

ü  Live Q&A with a utilization management expert.

ü  Recording of live presentations.

ü  Applied cases.

ü  Knowledge check quizzes.

ü  Presentation slides.                                                                                                                                                                       

Who Should Attend

Health care professional
Health care decision maker
Consultant
Health plan
Health system
Hospital
Wellness organization leverages in federal, state, employer

Faculty

Clint Koenig, MD

Vince Pereira

Continuing Education

This live course grants 4 Other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.

This is a non AMA PRA Category 1 CreditTM, ANA CNE, ACPE activity.

* Please note – You must attend the entire program to be eligible for total number of contact hours.

Disclosure of Relevant Financial Relationships

The 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.

For 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.

Disclosure 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.

Relevant financial relationships exist with the following companies/organizations:

Faculty:

Clint Koenig, MD: None

Vince Pereira: None

Additional Planning Committee Members:
Vince Pereira: None

Amelia Bedri: None

Zoya Shabbir: None 

Gerald Stewart: None 

Kimberly Waldron: None

This program was developed in part by NCQA staff.

Event Type

1. Live Online