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Case Management 

With our case management program, you never have to face extensive, long-term illnesses and injuries alone. Case management is a voluntary program, provided at no extra cost to members. We are dedicated to ensuring our members receive all the necessary health services needed to live a healthy life. 

In certain health situations, members may be eligible to work one-on-one with a case manager. A case manager is a specially trained professional, generally a registered nurse or occasionally a social worker. Members may be eligible to work with a case manager if they:

  • Have a qualifying complex, chronic, or rare condition
  • Are at risk for developing a complex or serious medical condition, which may be determined by a member's answers to the Health Risk Assessment that he or she completes
  • Have been involved in an accident or other catastrophic health event
  • Need assistance managing acute or chronic health care needs

Case managers can offer patients:

  • Help navigating the health care system
  • Assistance identifying, implementing, and monitoring health care needs
  • Education on their health condition and medication(s)
  • Help eliminate barriers to receiving medical care
  • Resources available in the community
  • Coordination of services such as home health, skilled nursing facilities, inpatient rehabilitation, hospice, durable medical equipment, and more
  • Assistance with care plans
  • Contact to check on the patient and answer questions 

Specific programs our case managers can help you with include:

  • Oncology
  • Right Start Prenatal Program
  • Transplant management
  • Palliative care
  • Complex case management
  • HIV and AIDS
  • Chronic kidney disease

Take control of your health and treat your conditions. Call our case management services at 1-877-878-8785, option 2, to get more information or to speak with a case manager. 

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