Case Management
Molina Healthcare provides a comprehensive Case Management (CM) program to all Members who meet the criteria for services. The CM program focuses on procuring and coordinating the care...
Molina Healthcare uses the Healthcare Effectiveness Data and Information Set (HEDIS®) tool every year for quality reporting. This is done by looking at the type of care and services provided. Along w...
Each year Molina Healthcare sets goals to improve our services to members. Annually we measure member satisfaction using the Consumer Assessment of Healthcare Providers and Systems survey (CAHPS®). Th...
The Molina Healthcare Quality Improvement (QI) Program provides the structure and key processes that enable the health plan to carry out its commitment to ongoing improvement of care and service, and ...
One of the goals of Molina Healthcare Utilization Management (UM) department is to render appropriate UM decisions that are consistent with objective clinical evidence. To achieve that goal, Molina He...
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Clinical practice guidelines are designed to guide decisions about diagnosing and treating specific health conditions. These guidelines are based on scientific evidence, medical literature reviews, or...
Preventive health guidelines can be beneficial for both providers and patients. These guidelines are based on scientific evidence, reviews of medical literature, or established authority. All recommen...
