Explaining HPA Standards for Utilization Management (UM)

About this On Demand Training

Cost $299

Explaining HPA Standards for Utilization Management (UM)

This OnDemand course provides a focused and thorough examination of the HPA Standards for Utilization Management (UM). Faculty will equip participants with tips for interpreting the requirements, navigating the standards, and avoiding common misconceptions. Faculty will also facilitate short activities to simulate how to address requirements.

This course presents information based on the requirements from the HPA 2020 Standards, which also applies to the HPA 2021 Standards. Therefore, the content of this course applies to NCQA Accreditation Surveys conducted between July 1, 2020 and June 30, 2022.

Note: Each participant must make an individual registration.

What You Will Learn

• Explain the intent of the HPA Standards for Utilization Management (UM).
• Describe relationships across the UM Elements.
• Identify common pitfalls and misperceptions regarding UM requirements.
• Apply knowledge of UM competencies through practical scenarios.

Who Should Attend

This OnDemand course is geared toward healthcare professionals who have a stake in case management, managed care, claim appeals or denials. These roles include but are not limited to: 

• Utilization Managers/Directors
• Case Management Specialists/Directors
• Behavioral Health Professionals
• Clinicians
• Quality Assurance Managers/Directors
• Quality Improvement Managers/Directors
• Regulatory Specialists/Managers/Directors
• Consultants/Contractors

Faculty

Frank H. Stelling, M.Ed, MPH

Mr. Stelling is a Senior Consultant with The Mihalik Group. Prior to joining the Mihalik Group, he was Assistant Director, Accreditation Policy at NCQA for 14 years. Mr. Stelling oversaw the Policy Clarification Support System (PCS), a web-based tool for customers to ask questions of Policy Accreditation staff concerning all NCQA Accreditation and Certification programs. He also directed all education efforts out of the Policy Accreditation unit. In addition, Mr. Stelling was the lead on all federal and state deeming activities, including the Medicare Deeming program.

Mr. Stelling is also an NCQA surveyor and has been part of survey teams for the accreditation of Health Plans, Managed Behavioral Health Organizations. Disease Management Organizations and other organizations for over 17 years. Mr. Stelling has over 40 years of experience in health care with focus on Preventive Services, Disease Management and Quality Improvement.

Before joining NCQA, he held management positions with state and county health departments, hospitals, voluntary health organizations and a managed care organization. He holds a Master of Education from the University of South Carolina and a Master of Public Health from the University of California, Berkeley.

Continuing Education

In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), and the Association of Social Work Boards (ASWB) to provide Interprofessional Continuing Education for the healthcare team. 

This activity was planned by and for the healthcare team, and learners will receive 3.0 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 3.0 AMA PRA Category 1 Credit^TM, ANA CNE, APA, ACPE and ASWB ACE.

The assigned universal program number: JA0004597-0000-20-018-H04-P. Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit.

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

Event Type

1. Self Paced