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Care
management

Care management gives you the personal support of a case manager. If you think you need extra help, just call 1-888-348-2922 (TTY: 711) and ask to talk to a case manager. Your doctor or caregiver can also call to sign you up for the program. Not sure if care management is right for you? Complete your health risk survey and we’ll help you find out. 

Questions?

You can call Member Services at 1-888-348-2922 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.

What does a case manager do?

What does a case manager do?

Case managers are nurses and social workers who work with both adults and children. They share info about your health conditions and ways to take care of yourself. They can also help you:

 

  • Find a primary care provider (PCP) or specialist
  • Schedule doctors’ visits
  • Find specialists and behavioral health services near you
  • Get rides to your doctor, pharmacy or hospital
  • Get medical and dental services, supplies and equipment
  • Find community resources and educational materials
  • Find home and community-based services

 

To help decide which services best meet your needs, the case manager works with:

 

  • You
  • Your provider
  • Your representative or guardian (if you have one)

 

During COVID-19, your case manager may work with you by phone or in person. They’ll ask you about your health and care needs. You can have family and others present, if you wish them to take part.

Managing chronic conditions

 

Some health issues need more care. If you’re managing a chronic condition, a case manager can help you get the treatment you need to feel better. They can help you manage conditions like asthma, diabetes, chronic obstructive pulmonary disease (COPD) and more. 

 

Chronic disease management

Pregnancy

 

Are you pregnant or planning to start a family? A case manager can help you stay healthy through your pregnancy. If your pregnancy is high risk, they can help you get the special care you need. You’ll get support, including info about preterm labor and birth. 

 

Pregnancy care

Substance use disorder (SUD)

Substance use disorder (SUD)

Case managers help members with SUDs get the care they need. They can help a member:

 

  • Get the right services to match where they are in the treatment process
  • Get medical care for any coexisting health issues 
  • Find recovery-based community resources, support and knowledge
  • Make sure their SUD provider and PCP work together on their care
  • Find peer support
  • Connect with an SUD champion in their area 
  • Find support groups like AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) 

 

Learn more about SUD benefits on our behavioral health page.

 

Behavioral health benefits

Children with Serious Emotional Disorder Waiver (CSEDW)

Children with Serious Emotional Disorder Waiver (CSEDW)

A CSEDW case manager can help members in this program:

 

  • Find the right services both in the program and in their local community
  • Work with the CSEDW wraparound facilitator and the child and family teams  
  • Get info and resources
  • Put together and carry out of the member’s Plan of Care
  • Review the CSEDW Plan of Care before it’s approved
  • Get prior authorization of CSEDW services
  • Make sure the Plan of Care includes a crisis plan and therapy plan

 

CSEDW program

Complete your health risk survey

 

This will help us decide on what level of care you need. Once you complete the survey, we’ll review your results and talk with you about your care options. You can learn more about the survey.

 

Health risk survey