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.
Envolve is committed to the provision of a well-designed and well-implemented healthcare Quality Improvement/Utilization Management (QI/UM) Program using reliable and valid methods of monitoring, analysis, evaluation, and improvement in the delivery of PBM services provided to all members.
We are proud to hold numerous NCQA certifications and URAC accreditations through our family of companies. We are dedicated to providing well-established quality processes that deliver results. We build our Quality Culture around achieving the Triple Aim for Healthcare Quality Improvement: improving population health, and improving efficiency/lowering health care costs. 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 Envolve's clients.
The purpose of the QI/UM Program is to provide client-driven and leadership-driven balanced framework and organizational structure to support the mission, vision, and strategic goals of Envolve, while enhancing client and member outcomes. Our ultimate purpose of measuring quality improvement in healthcare is to improve the health of the community, one person at a time.
Envolve substantiates the quality of PBM services we provide to our clients and members by monitoring and analyzing results in compliance with URAC accreditation standard audits. 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.