NCQA
Optum Health Networks, Inc.
1 Optum Circle Eden Prairie, MN 55344(952) 687-4103https://www.optumcare.com/
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Accreditations, Certifications & Distinctions

Last updated on 11/19/2024
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Case Management

This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.

Evaluation Product
program
Status
next review date
Case Management
Complex case management
Accredited - 3 years
11/03/2026
Evaluation Product
Case Management
program
Complex case management
status
Accredited - 3 years
next review date
11/03/2026
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Credentialing

This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.

Evaluation Product
Status
next review date
Accreditation in Credentialing
Accredited - 3 years
N/A
Evaluation Product
Accreditation in Credentialing
status
Accredited - 3 years
next review date
N/A
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Population Health Program

This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.

Evaluation Product
program
Status
next review date
PHP Accreditation
Diabetes Disease Management
Accredited - 3 years
05/19/2026
PHP Accreditation
Medical Behavioral Integration
Accredited - 3 years
05/19/2026
Evaluation Product
PHP Accreditation
program
Diabetes Disease Management
status
Accredited - 3 years
next review date
05/19/2026
Evaluation Product
PHP Accreditation
program
Medical Behavioral Integration
status
Accredited - 3 years
next review date
05/19/2026
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Utilization Management

This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.

The ‘Accreditation in Utilization Management’ status reflects accreditation for the utilization management functions in place at the time of the accreditation survey.

NCQA recommends that Health Plan organizations check with UM organizations prior to contracting to confirm functions included in the accreditation such as denial and appeal recommendations or decision-making.

Evaluation Product
Status
next review date
Accreditation in Utilization Management
Accredited - 3 years
01/06/2026
Evaluation Product
Accreditation in Utilization Management
status
Accredited - 3 years
next review date
01/06/2026

Why Accreditation Matters

Organizations that are accredited or certified by NCQA meet industry-leading standards for following best practices and providing high-quality care. Accreditation is also a signal that helps identify valuable contracting partners. Health plans that partner with an NCQA-Accredited/Certified delegate can create efficiencies within the delivery system and may reduce your oversight burden.

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