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The Quality Improvement (QI) Department identifies opportunities for improvement of care and services to both our members and providers. This is accomplished by assisting with the identification, investigation, implementation and evaluation of corrective actions that continuously improve and measure the quality of clinical and administrative service. This Quality Improvement Program covers all lines of business, including but not limited to Medi-Cal, and Medicare. A formal evaluation of the Quality Improvement functions is performed annually.
Specific key elements of focus for the Quality Improvement Department may include but are not limited to:
The Quality Improvement Program is designed to objectively and systematically monitor and evaluate the quality, appropriateness and outcome of care and services delivered to our members and to provide mechanisms that continuously pursue opportunities for improvement and problem resolution.