Quality Management
Molina Healthcare Quality Management (Molina QM) develops and implements policies and procedures to review, report, evaluate, and resolve Quality of Care (QOC) concerns, and service concerns raised by members/Health Care Decision Makers (HCDM)s, individual and organizational contracted providers, and stakeholders. Concerns are received from anywhere within the organization or externally from anywhere in the community including provider Incident, Accident, and Death (IAD) reports entered directly into the AHCCCS Quality Management (QM) Portal as specified in AMPM Policy 961. Molina QM also provides methods (e.g. email address, phone number, mail) for our team to receive concerns directly from the community, members, and HCDMs. Molina QM addresses all concerns regardless of reporting by external or internal sources. Molina QM ensures the QOC investigative framework, and resolution process is member-centric and prioritizes the member experience and member outcomes and evaluates if there are systemic concerns to be addressed as part of a QOC investigation.