BSN, RN, CCM, CPHQ
Tina has been instrumental in helping organizations.
Tina Morton is a Registered Nurse with over 25 years’ experience within healthcare including senior roles in quality management. Tina’s expertise is in behavioral health, quality management, case management, and utilization management. She has been an NCQA Administrative Surveyor since 2013. Tina joined Managed Healthcare Resources in 2018 as a Healthcare Consultant.
Tina has worked at three large organizations at a senior level in quality management, supporting various populations including Commercial, Medicaid, Medicare Advantage, Medicare Duals, and Special Needs Plans, locally and enterprise-wide across seven states.
Tina was the Corporate Director of Quality Management for AmeriHealth Caritas Family of Companies for two years, which included the Medicaid and Medicare product lines for seven states. As Corporate Director, Tina was responsible for oversight of Quality and Credentialing for ten plans (combined Medicaid, Medicare Duals, and Special Needs Plans) within the organization. The Quality Program included HEDIS, STARs, credentialing, and ongoing maintenance of enterprise compliance with regulatory, contractual, and NCQA accreditation standards.
While at Beacon Health Options in New Jersey, a Managed Behavioral Health Organization (MBHO), formerly known as Value Options, Tina was instrumental in designing and implementing HEDIS Initiatives, preparing for accreditation readiness, and collaborating with Horizon NJ Health and Horizon BCBS NJ on behavioral health projects.
At Keystone First Health Plan she progressed from Director to Corporate Director of Quality Management, where she oversaw quality management, credentialing ,delegation oversight, and developed a strategic focus for HEDIS, CAHPS, NCQA Accreditation, state audits, and standardization of key quality processes across the organization.
As an Administrative Surveyor for NCQA since 2013, Tina has surveyed multiple programs on behalf of NCQA including Managed Behavioral Health Organization, Health Plan Accreditation, Multicultural Health Care, Credential Verification Organizations, Case Management Long Term Services and Supports, and Population Health. Additionally, Tina participates in the Model of Care (CMS) review process.
Tina received a Diploma in Nursing from Our Lady of Lourdes School of Nursing, Camden NJ, and a Bachelor of Science in Nursing from Thomas Edison University in Trenton NJ. Tina has held a Certified Case Management (CCM) certification since 1998, is a Certified Professional in Healthcare Quality (CPHQ) by the National Association for Healthcare Quality since 1996 and was formerly a Fellow of the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) 1995- 2019, currently Emeritus.Return to Meet Our Consultants