Utilization Management Accreditation Benefits & Support

NCQA Utilization Management Accreditation benefits impact operational performance and marketplace competitiveness. Organizations seeking accreditation receive resources and support to help them during and after the evaluation process.

How does my organization benefit from accreditation?

NCQA Utilization Management Accreditation provides a framework for implementing industry best practices to help organizations:

  • Conduct fair and timely utilization management decisions using objective, evidence-based criteria: 
    • Collect and use relevant clinical information.
    • Use qualified health professionals to make decisions.
  • Align with state requirements.
  • Demonstrate their program’s quality to employers, regulatory agencies and health plans.

Where can we find resources?

Find more information about NCQA Utilization Management Accreditation here:

Additional support

  • The Policy Clarification Support (PCS) system, My NCQA and FAQs can help you interpret NCQA standards.
  • Policy Updates: Lists corrections, clarifications and policy changes to NCQA Standards and Guidelines.
  • Education and Training: NCQA offers a variety of training options, from on-demand, web-based programs to live, in-person seminars.
  • Seals: Print-friendly graphics for use in promoting NCQA status.
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