Peggy, RN, MS, Senior Consultant, Accreditation Services, is a seasoned healthcare consultant with prior experience as a URAC accreditation reviewer, as well as Manager of Workers' Compensation Services at URAC. During her tenure at URAC, Peggy contributed to the development of URAC's standards, performance measurement tools and to the URAC Interpretative guides used extensively by URAC applicants. Peggy served as faculty at many URAC conferences and workshops.

Since 2000, Peggy has developed consulting services at Professional Services Network, Inc. for NCQA, URAC and Joint Commission accreditation and has expertly guided many organizations toward successful URAC accreditation. Past experience includes the successful development of a Workers' Compensation UM Program for a national PPO, and the start-up of a hospital-based Home Health Agency. Peggy received her Master of Science degree, with a concentration in Nursing Administration and Health Services, from Georgetown University and her Bachelor of Science in Nursing from Boston College.

Judy, LCSW-C, MBA, brings diverse health care industry knowledge and experience, strong leadership skills, and demonstrated business acumen to her role as a consultant. She is particularly skilled in managed care operations, quality improvement, analytic studies, program development and evaluation, and project management. Her expertise extends to both private and public sector clients.

As a consultant Judy has assisted health plans and specialty managed care organizations in successfully submitting applications for NCQA and URAC accreditation, implementing new accounts and clinical programs, creating tools to enhance Quality Management programs, and developing promotional and educational materials for members and providers. Most recently, Judy completed a study for a large health system on regional access to behavioral health services that resulted in a major policy change at the state level. Judy also conducts systems performance reviews of managed care organizations providing services in Medicaid waiver states and jurisdictions. She has provided extensive training and individual consultation on performance improvement projects and compliance requirements. In addition, she served as a project manager for a CMS study focused on validating performance measures for Medicare Advantage organizations.

Prior to her current role, Judy held positions of increasing responsibility within both the provider and payer sectors. She began her career as a social worker at University of Maryland Medical Systems where she assisted with the development of a center of excellence for rehabilitation. Subsequently, Judy accepted a position with CareFirst BCBS where she served as Director of Marketing Research and Product Development and later as director of a strategic business unit with responsibility for sales, underwriting, customer service, claims processing, account installation, enrollment, billing and collections. Among her accomplishments was the development of a behavioral health subsidiary that was later sold for $53 million. Judy was president of a regional subsidiary of Magellan Behavioral Health, which was the first in the nation to achieve full NCQA accreditation under new industry criteria.

Shannon, RN, LNC, is a registered nurse and Legal Nurse Consultant specializing in quality, accreditation, risk management and survey readiness. She brings more than 15 years of successful accreditation and regulatory compliance experience with The Joint Commission (TJC), Community Healthcare Accreditation Program (CHAP) and State, Human Rights, Radiology and Laboratory surveys.

Prior to becoming a consultant with the PSN team, Shannon held positions as Chief Quality Officer and Director of Quality/Regulatory Compliance for small to moderate-size healthcare facilities. Her responsibilities included regulatory compliance, risk management/patient safety, survey readiness, quality management/performance improvement, infection control and safety. Shannon's experience includes project development, implementation of various processes/systems for process improvement, risk reduction, and compliance including CMS Value Based programs. She is able to evaluate standards, assess the facility's current process, and develop and implement processes or enhancements while keeping it simple.

Jessica, RN, is a registered nurse with over 29 years of extensive leadership and consulting experience in corporate business and medical management organizations. She has developed and managed clinical quality management programs, corporate regulatory compliance and clinical training programs. Past experience also includes the start-up development and design of programs for Health Call Center/Triage, Case Management, Utilization Management, Disease Management and Independent Review Organization. Professional experience encompasses the acute care hospital setting, hospital management, corporate medical management and corporate regulatory affairs.

On a national basis, Jessica has supported medical management program accreditation under both URAC and NCQA standards for Network Management, Utilization Management, Case Management, Disease Management, Health Call Center, Independent Review Organization and Pharmacy Benefit Management. Jessica also has prior consultant experience as a URAC accreditation reviewer. As a contracted reviewer for URAC, she supported accreditation reviews, URAC Compliance Reviews and the revisions of the interpretive guidelines for Health Call Center, Utilization Management and Core Quality and provided workshop education for the Health Call Center Standards.

Pamela, RN, MPH, has had over fifteen years experience in quality improvement and health care policy. In her many leadership positions, she has led the successful development of programs for disease management, credentialing, appeals and quality management, as well as worked with IT teams to develop the systems to support these programs. She is an expert communicator with corporate, national and local level experience and a change agent with experience in redesign of systems and corporate policies that resulted in a wide variety of successful quality improvement initiatives. Her expertise includes leading Medicare, Medicaid and commercial health plans to obtain accreditation from URAC and NCQA and has been a NCQA surveyor since 1996. She is an experienced health policy authority with extensive knowledge of private insurance, Medicare and Medicaid, as well as significant experience with state and federal lobbying. As the QI leader in many settings, she has provided training on quality improvement and performance measurement. Pamela is a registered nurse with a Masters in Public Health from the Johns Hopkins School of Public Health.

Ellen, RN, MSB, is a healthcare executive with more than 25 years of diversified experience in developing, training, implementing, supporting, and promoting health services strategies. Ellen has been an active NCQA surveyor since 1991 and helped to develop many of the NCQA Accreditation and Certification products. Through her hands-on and personable consulting approach, Ellen has successfully guided many organizations towards successful NCQA Health Plan Accreditation and NCQA Disease Management Accreditation and Certification.

Her past experience includes development and monitoring of strategic business plans; project management; policy and standards development; budget development and accountability; and regulatory and accreditation compliance.

Ellen has prior experience as an Assistant Director of Accreditation Operations/ Surveyor at the National Committee for Quality Assurance's (NCQA) office in Washington, DC. As Regional Director of Quality Management with a national health plan, Ellen actively participated in quality management, medical management, sales and marketing services to facilitate appropriate healthcare utilization, and to improve the quality of the healthcare program for 350,000 members. She re-engineered unit processes to exceed targeted organizational compliance goals and numerous service levels and medical costs to within standard.

Ellen obtained her RN, BSN degree from the American University and her Master's of Science in Business and Finance from the Johns Hopkins University. Ellen holds an active license as a Registered Nurse in Virginia.