Delegation Compliance Specialist

Slides:

Advertisements

Similar presentations

Alabama Primary Health Care Association

Advertisements

2.2. Challenges and Limitations to Oversight Andres Soosaar, Estonia.

Financial Literacy for Executives and Non-financial Staff Bonnie Janicki, Corporation for National and Community Service.

OPERATING EFFECTIVELY AT WESD. What is Internal Control? A process designed to provide reasonable assurance the organizations objectives are achieved.

Managing Risk: A Framework and Reporting Cycle 2014.

Pursuing Effective Governance in Canada’s National Sport Community June 2011.

Process and Procedure Documentation. Agenda Why document processes and procedures? What is process and procedure documentation? Who creates and uses this.

VISN 20 Multi-Site IRB. VISN 20 Institutional Review Board Who we are: VISN 20 includes the states of Alaska, Washington, Oregon, most of the state of.

Preparing for Compliance Monitoring Reviews Understanding CMS Protocols Used by Review Organizations January 14, 2009 Presented by: Margaret deHesse, RN,

RMS – a collaborative approach Presentation Lyn Dare & Stephen Larmour Authorisation & Audit Comcare.

5/2010 Focused Monitoring Stakeholders May /2010 Purpose: Massachusetts Monitoring System  Monitor and evaluate program compliance with federal.

U.S. Department of Veterans Affairs Veterans Health Administration Supportive Services for Veteran Families (SSVF) Program SSVF Grantee Uniform Monitoring.

Internal Control.

Audit Committee in Albania Legal framework Law 9226 /2006 “On banks in Republic of Albania” Law 9901/2008 “On entrepreneurs and commercial companies” Corporate.

ClASS MODULES: BREAKOUT SESSIONS. ClASS ADMINISTRATIVE MODULE.

External Quality Review Process August 6, The Carolinas Center for Medical Excellence (CCME) A physician-sponsored, nonprofit health care quality.

How to Prepare for a FTCA Site Visit Office Hours

WellCare SNP Model of Care Program

Managing Sponsorship Research Services University of Oxford.

Internal Control and Internal Audit

ClASS MODULES: BREAKOUT SESSIONS. ClASS FINANCIAL MODULE.

HEDIS Audit – Appropriate Monitoring and Oversight of Vendors Presenter: Yolanda Strozier, MBA Project Manager, EQRO Services.

Legal & Administrative Oversight of NGOs Establishing and Monitoring Performance Standards.

Staff Structure Support HCCA Special Interest Group New Regulations: A Strategy for Implementation Sharon Schmid Vice President, Compliance and.

Equity Housing Group Risk Management. 05 August 2002 © MazarsEquity Housing Group: Risk Management 2 Agenda Introduction: what is Risk Management? The.

Page 1 Presentation to the Portfolio Committee on Tourism Fundamentals of effective Internal Control 21 July 2010.

Portfolio Committee Presentation Government printing Works Audit and Compliance 07 May 2013 Presented by: Chief Executive Officer.

Internal Audit’s Role in Compliance Laurisa Riggan, CPA, CHE Children’s Mercy Hospitals and Clinics September 26, 2000.

Award Monitoring Update National Science Foundation Advisory Committee for Business and Operations October 22, 2003 Mary Santonastasso, Director, Division.

Evaluation of Internal Control System. Learning Objective 1 Contrast management’s need for internal control with the auditor’s need to consider internal.

DEFINITION Quality assurance is the process of verifying or determining whether the products or services meet or exceed the customers expectations. Quality.

BSA PROGRAM REQUIREMENTS.  Written, approved by the board of directors, and noted in the board minutes.  Based on the risk assessment  Fully implemented.

NCQA Standards Update & Delegated Credentialing Tips NYSAMSS Annual Meeting – May 4, 2012 By: Di Hall, CPCS, CPMSM Director, Compliance & Quality Improvement.

Quality control of studies in Lithuania Renata Bilbokaitė, The highest specialist for quality Šiauliai university.

Purpose of Volunteer Selection The primary purpose of volunteer screening is the protection of the youth enrolled in our programs, our volunteers and our.

2004 Credentialing & CVO Standards National Credentialing Forum February 20, 2004.

Office of Human Research Protection Georgia Health Sciences University.

Multistate Research Program Roles & Responsibilities Eric Young SAAESD Meeting Corpus Christi, TX April 3-6, 2005.

North Carolina Association Medical Staff Services May 27, 2016 Renee Aird Dengler, RN, MS, CPMSM, CPCS NCQA CVO & NCQA CR Certification.

What is Program Evaluation? Allegheny Intermediate Unit Evaluation, Grants, and Data.

Responsibilities of Sponsor, Investigator and Monitor

An exposure to COMPLIANCE AUDIT By- Vishal Chawre DAG(A/c & VLC) O/o AG(A&E), Nagpur.

Snapshots of 2015 Human Ethics from the Annual Chairs Committee Report.

JOINT COMMISSION PANEL

Roles & Responsibilities of an Impressive Program Governance Plan

2016 Presented by: Raffi Soghomonian

Responsibilities of Sponsor, Investigator and Monitor

Diana K. “Di” Hall, CPCS CPMSM – Sr. Director, Compliance & Quality

Establishing and Understanding a CVO

Session D: The Accreditation Process.

SACSCOC Fifth-Year Readiness Audit

IIASA Governance Review

AMCH PPS PAC Executive Committee Meeting August 27, 2015

Corporate Governance Corporate Governance also plays an important role in maintaining corporate integrity and managing the risk of corporate fraud, combating.

Disaster Relief – You and Your Emergency Preparedness Plan

MAMSS Delegated Credentialing Panel May 19, 2016

Welcome to Essex Clerks Association

ROADMAP TO ISO/TS REGISTRATION

Structure of the Internal Audit Service

School Site Council (SSC) Training

Delegated Credentialing: Do You Know Where to Start?

Consent Training Module

CORPORATE & ACADEMIC GOVERNANCE STRUCTURE

Mr Mirco Barbero European Commission, IAS.C1

Module 3 Part 2 Developing and Implementing a QI Plan: Planning and Execution Adapted from: The Health Resources and Services Administration (HRSA) Quality.

Fourth Annual Medical Research Summit April 21-23, 2004 Evolution of an IRB Quality Improvement Program Ada Sue Selwitz, M.A. Director, Office of Research.

Process and Procedure Documentation

HUD’s Coordinated Entry Data & Management Guide

Experiences Engaging Managed Care

Presentation transcript:

Delegation Compliance Specialist Presented by: Jennifer Stoppel Delegation Compliance Specialist Medica Health Plan

Delegation What is it? Misconceptions Risks Efficiencies Partnership/relationship Process improvement

Delegation continued: Pre-delegation process Criteria Completion of pre-delegation assessment form Evaluate policies, procedures, credentialing plan, etc. On-site file audit

Delegation Approved Oversight of the delegation arrangement NCQA standards

Responsibilities Health Plan Annual on site audits including: File review Policy, procedure, credentialing plan review Credentialing committee meeting minute review Interview with credentialing staff Approval of audit findings, which may include corrective action plan based on committee decision

Responsibilities continued Delegate Monthly/weekly reports Ongoing monitoring Policy updates Reporting of sanctioned providers Semi-annual reporting Participation in annual on-site review

Efficiencies Credentialing Collaborative Health plans that participate Purpose of the collaborative How the collaborative functions