Sheila M. Petras
MSHA, RN, CPHQ

Sheila has over 25 years consulting experience. 

Sheila Petras is an independent consultant who has worked in health care quality for over 25 years.  She has successfully led a quality management department and implemented quality improvement programs including NCQA and URAC accreditation.

Her expertise is in the managed care arena working with people to improve outcomes.

Sheila Experience includes the following types of activities:

  • Authored and prepared documentation for accrediting organizations to showcase standards compliance and improvement activities
  • Develop, implement, and evaluate quality improvement programs
  • Monitor utilization management program for regulatory compliance
  • Collaboration with regulatory agencies on quality improvement initiatives for measurement, patient-centered medical homes, data reporting, and transparency
  • Developed and implemented strategies to improve quality metrics including clinical metrics, and satisfaction metrics.
  • Developed and implemented programs for member and provider education, outreach through various media.
  • Identified quality indicators for both care and service to include ongoing monitoring, reporting, and evaluation of effectiveness.

In 2013 Sheila became an NCQA Administrative surveyor and has participated in accreditation surveys for various types of organizations including Health Plans, Behavioral Healthcare Organizations, and smaller specialty organizations such as Credentialing Organizations, Utilization Management Organizations, and Case Management Organizations

Since joining MHR Sheila has assisted many organizations in preparing for NCQA survey.  Activities include gap assessments, mock file reviews, and document review/revision.

Sheila received her Bachelor of Science degree in nursing from Maywood College, Scranton, Pennsylvania, and a Master of Science in health administration from the University of Scranton.  She has maintained her certification as a healthcare quality professional since 2000.

 

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