Managed Healthcare Resources

Specializing in NCQA Accreditation Preparation. 

MHR is a boutique consulting firm with NCQA surveyor consultants. We guide, mentor and challenge organizations to meet NCQA accreditation requirements.

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Managed Healthcare Resources (MHR) builds partnerships throughout the entire process. 

MHR has been helping prepare clients across the United States prepare for and successfully complete the NCQA accreditation since 1991. 

Our consultants have varied and vast experience with the application of standards and how to meet accreditation standards. 

MHR understands that each client has a unique set of needs and in turn creates a consulting plan that is unique to them. 

Knowledge

For over 30 years, MHR president Susan Moore has been working with NCQA accreditation. She believes in sharing her knowledge both with the highly trained consultants she hires and the clients she works with. 

All consultants have experience with the NCQA accreditation process. 

Experienced

Our diverse team has worked with many organizations and staff that are new to accreditation. We support you through the entire complex process. 

MHR consultants joined the team because they wanted to share their vast experience in helping organizations be successful. 

Collaboration

MHR believes in a flexible approach with their clients to develop a comprehensive plan of activities needed to meet accreditation. 

MHR has worked with many organizations new to the accreditation process. We support you throughout the process. 

Most MHR clients score 99-100% of the possible points. 

Who we work with

Our diverse team has worked with many organizations and staff that are new to accreditation. We support you through the entire complex process.

We've worked with: 

  • Health Plans (managed care)
  • Physician Organizations
  • Managed Behavioral Health Organizations
  • Population Health Organizations
  • Case Management Organizations
  • Special Needs Plans
  • Wellness Vendors 
  • Health Equity
  • And more 
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“I have worked with MHR at four health plans, and the MHR expertise has pulled me out of quicksand more times than I can count. ”

 

- HP, VP Quality & Accreditation

"Thank you Susan! We are very excited about our 100% and truly appreciate all of the work that Jean did to help us get there, she was absolutely wonderful to work with and we could not have done this without her!"

 

- Kristin, Project Manager

"Susan is an exceptional NCQA consultant. I've had the pleasure of partnering with her in several organizations. In all instances, we received the highest ranking of NCQA accreditation possible."

 

- Vernal, Director Performance Excellence & Quality

"You truly have the best and most talented staff. I have nothing but the highest praise and appreciation for you and your team regarding the great guidance provided to ensure our successful surveys. The one thing I am the most grateful and appreciative of is your perpetual positive, can-do attitudes; there were many steps along the way where your energy and positivity was exactly what I needed."

 

- Karen, Director Compliance and Accrediation

"The MHR Team has been an outstanding resource to us through two NCQA Health Plan surveys. When the MHR team arrived, they conducted a critical review of our policies, reports, and files, then proceeded with training our staff and leadership on all NCQA standards, including focused training on UM standards, using real-world examples. They suggested how we could improve our reports and letters to meet the standards. We attribute our successful surveys to the MHR team for working closely with us, training our staff, and advocating for us with NCQA. In addition, they performed rigorous and thorough document reviews, and mock file audits to ensure compliance with NCQA requirements. Working with MHR was a great experience. They were timely and thorough. There were no instances where they did not meet our expectations. We are very appreciative."

 

- Anonymous, Leader of Accreditation and Quality, Northeast Health Plan

"MHR’s training on NCQA Health Plan Accreditation resulted in our staff gaining self-confidence, improving on quality analysis reports, and being more independent in interpreting standards and making decisions. Our initial training was delivered by Susan onsite and virtually, for two days, where up to 200 people attended from our nationwide accounts. Susan not only discussed NCQA standards, but she also explained how federal and state regulations impacted the standards. She gave real-life examples that staff related to in their everyday work. Being available for questions and answers allowed staff to ask about their unique circumstances. Also, during our preparation for submission, Susan held virtual file reviews for UM denials and appeals, case management, and credentialing/recredentialing, which helped staff in each area develop their skills and meet all standards. Then annually, MHR provided sessions on updates to the standards where teams participated onsite and virtually. I definitely recommend MHR’s training, onsite, if possible, with representatives from all areas, particularly those who are responsible for writing reports and managing files. We were very appreciative of MHR’s training methods and their ability to work with all levels of staff and respond to our individual needs. I would score them a 5/5!"

 

- Director Quality/Accreditation, National Health Plan

 

We meet you where you are & take you where you need to be. 

Our team is predominantly comprised of current NCQA surveyors, and the majority of the consultants are registered nurses. 

We've developed trainings for our clients that are customized to your specific needs. We have also created a number of templates and tools that can be purchased to help with the accreditation process. 

Let's Connect

We'd love to connect with you to see how a partnership can help your organization successfully complete the NCQA accreditation process. 

Complete the quick form below and we will be in touch.