Compliance and risk management are growing in importance as managed care organizations increasingly turn to delegated entities to reduce operating costs and streamline operations. Amid the benefits of outsourcing, there lies a significant risk. Simply stated, responsibility and liability cannot be outsourced. Managed care organizations now face increasing pressure from their regulators, to demonstrate that they are proactively taking steps to mitigate risks by ensuring compliance among their delegated entities. Join us for this presentation with Tom Goddard and Ellen Pauley of Integral Healthcare Solutions, LLC, in which they will outline best practices for managing and minimizing third party risks with delegated entities. The presentation will focus on:
Real world examples will be used to illustrate key points and recommendations Who Should Attend
About the PresentersThe CEO of Integral Healthcare Solutions, LLC, Thomas G. Goddard, JD, PhD, is one of the industry’s premier URAC analysts. He served as Chief Operating Officer and General Counsel of URAC, and since leaving that organization has over seen a firm that has specialized for 9 years in working with applicants for URAC accreditation. Ellen Pauley, RN, MS, served as Assistant Director of Accreditation Operations/ Surveyor at NCQA's office in Washington, DC. Over the last 18 years, she has served both as an NCQA review and as one of the nation’s premier consultants to organizations seeking NCQA accreditation.
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ABOUT COMPLIANCE 360 FOR HEALTH INSURANCE Compliance 360 is the leading provider of enterprise governance, risk management, compliance and internal audit solutions for health insurance companies. With these solutions, health insurance companies reduce risks, improve efficiencies and protect their brands using a single platform to address their comprehensive GRC requirements. Compliance 360 helps health insurance companies address accreditation with NCQA and URAC, State and Federal regulatory mandates including Medicare Part D, OIG corporate integrity agreements, 3rd-party “delegated entity” compliance and State-specific market conduct exams, as well as audits of medical claims and medical records including Medicaid MIC audits and Medicare claims audits. Over 150,000 active users rely on Compliance 360 everyday to manage their risk, audit and compliance programs. To learn more about the Compliance 360 solution for insurance, visit our site today. ABOUT INTEGRAL HEALTH SOLUTIONS Integral Healthcare Solutions improves the delivery of health care services around the world by helping health care organizations meet quality, ethical, and legal standards. The mission of Integral Healthcare Solutions is to provide world-class consulting and education services to healthcare organizations in accreditation, quality management, and compliance. FOLLOW COMPLIANCE 360
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