Sheila M. Petras
MSHA, BSN, RN, CPHQ
Sheila has over 25 years consulting experience.
Sheila Petras is a Registered Nurse with over 25 years’ experience in health care quality and with NCQA standards. She has successfully led a quality management department and implemented quality improvement programs, including NCQA and URAC accreditation. She became an NCQA Administrative Surveyor in 2013. Sheila joined Managed Healthcare Resources in 2017 as a Healthcare Consultant.
Before consulting with MHR, Sheila was the Director of Quality at Blue Cross of Northeastern Pennsylvania where her experiences with accreditation and quality included:
- authoring and preparing documentation for accrediting organizations including NCQA to showcase standards compliance and improvement activities
- developing, implementing, and evaluating quality improvement programs
- monitoring utilization management program for regulatory compliance
- collaborating with regulatory agencies on quality improvement initiatives for measurement, patient-centered medical homes, data reporting, and transparency
- developing and implementing strategies to improve quality metrics including both clinical and satisfaction metrics
- developing and implementing programs for member and provider education outreach through various media
- identifying quality indicators for care and service including ongoing monitoring, reporting, and evaluating effectiveness
Since joining MHR Sheila has assisted many organizations in preparing for the NCQA accreditation survey. Some of those activities include: a gap assessments, mock file reviews, and document review/revision.
In 2013 Sheila became an NCQA Administrative Surveyor and has participated in accreditation surveys for various types of organizations including Health Plans, Behavioral Healthcare, Credentialing, Utilization Management, and Case Management.
Sheila received her Bachelor of Science in Nursing from Maywood College, Scranton, Pennsylvania, and a Master of Science in Health Administration from the University of Scranton. She is a Certified Professional in Healthcare Quality Professional (CPHQ) since 2000.
Sheila enjoys golfing, board games, reading, and gardening.
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