Explaining HPA Standards for Utilization Management (UM)

Explaining HPA Standards for Utilization Management (UM) is organized by National Committee for Quality Assurance (NCQA).

Course opens: 01/01/2021
Course expires: 12/31/2021

Target Audience:
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

Overview:
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.

Learning Objectives:
• 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.