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Curriculums

BluePeak offers recommended curriculum packages for organizations as an efficient and easy way to provide a training program for employees. Any course can be purchased stand-alone or you can build your own customized curriculum. Select the Core Curriculum on its own to meet regulatory standards or build a complete training program by adding an additional course or curriculum package to meet your organization’s education and training needs.

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The CORE Curriculum provides each of the required regulatory annual trainings. These courses are customizable for your organization and are updated annually. Each course concludes with a knowledge assessment and awards a certificate for passing. Organizations will receive pass/fail reporting for each individual for their records. Consider BluePeak University your one-stop shop to ensure all annual requirements are met.

  • 2023Annual HIPAA Training
  • 2023 Annual FWA Training
  • 2023 Annual Compliance Training

These effective and concise trainings are perfect for your executives on your Board of Directors and Compliance Committee members. Created with your busy executives in mind, these trainings will ensure that they have the necessary and required information to continue their roles in complete compliance.

  • 2023 Annual Board of Directors Training
  • 2023 Annual Compliance Committee Training

This curriculum consolidates all the best from our subject matter experts on Medicare Audits from A-Z. Since 2013, BluePeak has conducted over 500 CMS Mock Audits and onsite support projects for clients undergoing actual CMS program audits and since 2016, BluePeak has conducted over 100 Validation Audits. All this experience and expertise has been invested into these courses and offered to your organization. Select the entire package for your team or select a few to build your own program based on your organization’s specific needs.

  • 2023 CMS Audits: Helpful Hints and Common Findings
  • 2023 Program Area Universe Trainings (includes 1 module for each program area)
    • Formulary Administration (FA)
    • Part D Coverage Determinations, Appeals and Grievances (CDAG)
    • Part C Organization Determinations, Appeals and Grievances (ODAG)
    • Special Needs Plans Care Coordination (SNPCC)
    • Compliance Program Effectiveness (CPE)
  • Developing a Robust Audit and Monitoring Plan
  • Findings Happen – How to Complete Your Corrective Actions
  • How to conduct an effective Root Cause Analysis
  • Intro to Call Log Reviews
  • Learn More About MMP Audits
  • One-Third Financial Audit Overview

Looking for a well-rounded compliance training program for your newer employees? Or maybe a refresher for your trusted Compliance Department team? The Compliance Curriculum package offers a robust list of courses that ensures your team is knowledgeable on everything from the “Seven Elements of an Effective Program Audit”  to “Delegation Oversight” to the “Costs of Non-Compliance.” Select the entire package for your team or select a few to build your own program based on your organization’s specific needs.

  • Best Practices in Managing Guidance
  • Building an Effective Medicare Risk Assessment
  • Compliance Program Effectiveness (CPE) Boot Camp
  • Delegation Oversight – What Does That Mean?
  • Everything You Need to Know About the Seven Elements of an Effective Program Audit
  • Intro to PBM Oversight
  • The Cost of Non-Compliance
  • What is a RADV Audit and How do I Prepare?

The Pharmacy curriculum has everything you need to get your Part D team up-to-date with the most current regulatory standards as well as BluePeak’s proprietary best practices. The Pharmacy curriculum is also perfect for any cross-departmental training you may need.

  • Medicare Part D Coverage Determinations 101
  • Medicare Part D Appeal & Grievances 101
  • Medicare Part C Organization Determinations 101
  • Medicare Part C Appeal & Grievances 101
  • Intro to PBM Oversight

We have combined all our Utilization management 101 courses into one complete curriculum. At the completion of this curriculum staff will understand plan requirements, policies, and procedures related to Medicare Part C Organization Determinations and Part D Coverage Determinations and Appeals and Grievances for Part C and Part D.

  • Medicare Part D Coverage Determinations 101
  • Medicare Part D Appeal & Grievances 101
  • Medicare Part C Organization Determinations 101
  • Medicare Part C Appeal & Grievances 101

The Customer Service curriculum provides everything you need for training your Medicare Customer Service and Call Center team. Completing these courses will give your team the complete understanding and confidence in effectively manage different call types and resolve member questions and concerns on the first call, importance of call log reviews for audit success and provides suggestions on call center oversight and Identify and define both Medicare Part C and D appeals and grievances.

  • Call Center Boot Camp
  • Call Center Compliance That Works
  • Intro to Call Log Reviews
  • Medicare Part C Organization Determinations 101
  • Medicare Part C Appeal & Grievances 101
  • Medicare Part D Coverage Determinations 101
  • Medicare Part D Appeal & Grievances 101
  • Fundamentals of Key Claim Department Functions
  • Medicare Claims Oversight and Audit Masterclass
  • Medicare Claims Processing: Getting Started
  • The Claims Processing Compliance Playbook

Pair up risk assessment and one-third financial audits for this compelling overview of finance related trainings. Learn more about tools available and how to mitigate risks.

  • One-Third Financial Audit Overview
  • Understanding Risk Adjustments

Still looking for a little more? Consider one of these standalone trainings or pair with one of the above courses or curriculums.

  • Beginner’s Guide to Enrollment
  • CMS Star Ratings: Understanding the Basics
  • Employer Group Waiver Plan (EGWP) Boot Camp
  • Medicare Marketing Material Development
  • PACE: An Audit Notice May Be Coming!

“I felt the training was put together in a way that was easy to understand. The assessment was hard but it’s about focusing on the details and that’s something that’s needed with grievances.”

Grievance Analyst Supervisor, Sr. Markets

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