Janice Acar
Janice Acar, R.N., B.S.
Project Manager
Ms. Acar contributes to IPRO's External Quality Review (EQR) contracts for the Commonwealth of Kentucky, and the States New York and New Jersey. She leads IPRO’s EQRO contract with the State of Rhode Island. Her experience includes the following external quality review activities: conducting focused quality of care studies, monitoring Managed Care Organization (MCO) compliance with state and federal managed care regulations and requirements, encounter data validation, member and provider surveys, validation of MCO-reported performance measures and MCO-conducted performance improvement projects, and overall assessment of the quality, timeliness, and access to health care services provided by Medicaid MCOs.
From 2005 through 2008, Ms. Acar was project lead for the Centers for Medicare and Medicaid Services (CMS) Deeming Validation Review project, in which IPRO conducted validation reviews of national accreditation organizations that were granted deeming authority for MAO oversight by CMS..
She was also project lead for the Medicare Special Study, Medicare Advantage Quality Review Organization (MAQRO) from 2000 - 2008. The MAQRO was responsible for the development of reporting, review and scoring protocols and tools, the related instructional guides and training materials, and for review of MAO (Medicare Advantage Organization) quality improvement projects, as well as the review of MAO Chronic Care Improvement Programs, which was a new CMS MAO requirement implemented in 2006.
Ms. Acar has supervised the development, implementation and ongoing operation of various Medicaid and Medicare quality improvement projects, has assisted in the design and conduct of data validation studies, and has participated as a secondary auditor for HEDIS® and QARR audits.
Ms. Acar has conducted on-site visits to Managed Care Organizations (MCOs) to monitor compliance with state and federal requirements and provide technical assistance to MCO staff.
She has a Bachelor of Science degree in Nursing from the State University of New York at Stony Brook.