Quality Oversight & Utilization Alignment Training

Info: Month 3 – Quality Oversight and Utilization Alignment
Focus: Sustaining quality through supervision and utilization management.
Topics
• Service authorization, eligibility, and medical-necessity documentation
• Linking documentation to amount, scope, and duration of services
• Supervisory chart reviews and feedback methods
• Using QA and UM data to guide continuous improvement
Objectives
• Reduce findings related to authorization, eligibility, or supervision
• Embed documentation oversight into everyday supervisory practice
Relevant Review Citations
• iSPA E.2.C: Required elements of evaluation/re-evaluation, eligibility timelines, and compliance documentation.
o Utilization Management Themes: Service authorization (amount, scope, duration), medical necessity, and monitoring authorizations.
o Clinical Supervisor Role in QA: Best practices for supervisory chart reviews and documentation monitoring.

Know what’s Happening Next — before everyone else does.

Get App

Host or Publisher Northern Michigan Regional Entity