FAQ Directory: Case Management

Filter Results
  • Save

    Save your favorite pages and receive notifications whenever they’re updated.

    You will be prompted to log in to your NCQA account.

  • Email

    Share this page with a friend or colleague by Email.

    We do not share your information with third parties.

  • Print

    Print this page.

11.15.2012 Eligibility for Case Management (CM) What organizations are eligible to pursue Case Management Accreditation?

NCQA considers entities that perform relevant functions to be eligible for NCQA CM Accreditation, including, but not limited to: CM organizations, population health management organizations, health plans (HP), managed behavioral healthcare organizations (MBHO), provider-based organizations– including medical groups, hospitals, integrated delivery systems, patient-centered medical homes (PCMH) and accountable care organizations (ACO), community care teams.

CM 2014

10.15.2012 Standards Does NCQA require specific certifications for organization staff?

While NCQA does not include in requirements that your staff to hold specific certifications for case management, NCQA does have standards requiring organizations to verifying licensure for clinical staff who are required to maintain a license. "Clinical staff" is defined as individuals who are licensed to treat patients. Organizations would determine which certifications are appropriate for staff serving their patient population.

CM 2014