Envolve is committed to providing a well-designed and well-implemented healthcare Quality Improvement/Utilization Management (QI/UM) Program using reliable and valid methods of monitoring, analyzing, evaluating and improving the delivery of pharmacy benefit management (PBM) services provided to members.
The purpose of the QI/UM Program is to provide client and leadership-driven balanced framework and organizational structure to support the mission, vision, and strategic goals of Envolve, while enhancing client and member outcomes.
By measuring quality improvement in healthcare, we can see the impact our services are having on the health of the community, one person at a time.
Envolve's family of services have been recognized, over the years, for our commitment to providing clinical and service excellence to the individuals and clients we serve.
We are proud to hold numerous NCQA certifications and URAC accreditations through our family of companies. Our well-established quality processes deliver results.
We build our Quality Culture around achieving the Triple Aim for Healthcare Quality Improvement. This consists of:
We are also committed to the fourth leg of a Quadruple Aim: improving the work life of our network providers and their staff, as well as their experience and satisfaction with our health plan partners.
Envolve monitors and analyzes results in compliance with URAC accreditation standard audits to substantiate the quality of the PBM services we provide.
Some of the ways we work toward healthcare quality improvement within Pharmacy Benefits Management are:
Envolve ensures ongoing quality improvement through review, appropriate action, and follow-up. Envolve does this by:
Envolve is NCQA and URAC-accredited Quality Management Program provider committed to providing clinical and service excellence to everyone we serve. Contact us today and learn more about our comprehensive healthcare quality improvement program.