Leadership

This committee focuses on maintaining and improving the quality of care. Along with developing and reviewing medical review criteria and reviewing patient utilization and care issues, this committee is responsible for recommending both new providers and those up for re-credential to the Board of Directors for approval. This committee also oversees the development and maintenance of our disease management programs.

A sub-committee of the Quality Management Committee, the Pharmacy and Therapeutics Committee develops and reviews criteria for medication authorization and recommendations on formulary changes. It also reviews employers’ pharmacy utilization and advises them on benefit redesign where appropriate.

This committee reviews the terms and conditions of proposed contracts from third party administrators and health plans for recommendation to the Board for approval. This committee also gives input to the Board of Directors on network expansion and establishing quality and utilization incentives.