Quality Management and Improvement Committee Sample Clauses

Quality Management and Improvement Committee. The Contractor shall establish an internal Quality Management and Improvement Committee to develop, approve, monitor and evaluate the Quality Management and Improvement Program and Work Plan. The same committee may be responsible for both the Contractor’s Hoosier Healthwise lines of business. The Contractor’s Medical Director and Pharmacy Director shall be active participants in the Contractor’s internal Quality Management and Improvement Committee. The committee shall be representative of management staff, including provider relations, Contractor departments and community partners, advocates, members and subcontractors, as appropriate. Subcontractors providing direct services to members shall be represented on the committee. The Contractor shall have appropriate personnel attend and participate in OMPP’s regularly scheduled Quality Strategy Committee meetings. The Contractor is encouraged to recommend attendees and other stakeholders to Quality Strategy Committee meetings. Additionally, the Medical Director shall attend and participate in OMPP’s Quality Strategy Committee meetings at least quarterly to update OMPP and report on the Contractor’s quality management and improvement activities and outcomes. The Contractor shall have a structure in place (e.g., other committees, sub-committees, work groups, task forces) that is incorporated into, and formally supports, the Contractor’s internal Quality Management and Improvement Committee and Quality Management and Improvement Program Work Plan. All functional units in the Contractor’s organizational structure shall integrate their performance measures, operational activities and outcome assessments with the Contractor’s internal quality management and improvement committee to support the Contractor’s quality management and improvement goals and objectives.

Quality Management and Improvement Committee. The MCO must establish an internal quality management and improvement committee to develop, approve, monitor and evaluate the Quality Management and Improvement Program and annual plan summary assessment. The MCO’s Medical Director must be an active participant in the MCO’s internal quality management and improvement committee. The committee must be representative of management staff, MCO departments and community partners, advocates, members and subcontractors, as appropriate. Additionally, the Medical Director must attend the Hoosier Healthwise Quality Improvement Committee (QIC) meetings at least quarterly to update OMPP and report on the MCO’s quality management and improvement activities and outcomes. The MCO must have other appropriate personnel attend the Hoosier Healthwise QIC meeting monthly. The MCO must have a structure in place (e.g., other committees, sub-committees, work groups, task forces) to incorporate into, and formally support, the MCO’s internal quality management and improvement committee and quality management and improvement plan. All functional units in the MCO’s organizational structure must integrate their performance HOOSIER HEALTHWISE STATE/MCO CONTRACT CONTRACT ATTACHMENT 1: MCO SCOPE OF WORK measures, operational activities and outcome assessments with the MCO’s internal quality management and improvement committee to support the quality management and improvement plan’s goals and objectives.