Case Management Strategies
Why is case management important?
One of the
biggest challenge in managing healthcare is finding access to specific
types of health care where and when people need it.
Case Managers are a valuable resource
to help ensure that employee gets the health services and benefits
they need to make the best recovery possible.In cases
where a worker has injuries or personal circumstances that complicate the
recovery process, the case manager will act as their advocate and advisor,
assisting their progress through a sometimes complex health care and benefits
system. Case management’s role is to coordinate and facilitate access to timely
and appropriate health care services, and ensure continuity throughout the
recovery process.
What We Offer
Our team of case managers is dedicated to improving the quality of health of our
members; especially those with unique and complex care needs. Case managers are
skilled in helping members learn how to identify needs and access appropriate
services.
St. John’s offers a multi-disciplinary approach to providing resources to
improve members’ health. Case managers work with physicians and other providers
to assist members with their health care needs in a variety of ways, including:
Disease
specific education materials
Call center
support
Community
support services
How We’re Different
All of our
programs are developed, reviewed and updated with St. John’s Health
System involvement and oversight at every level. A local Medical
Director is available to provide timely decisions.
Case management benefits
Coordination of medical care through Utilization
Management and Prior Authorization ManagementCollaboration with the PCP and improved communication
with the multidisciplinary teamHealth education and health plan benefit educationInformation regarding community resourcesInformation regarding support groupsAssistance with applications for financial aidReferrals for disease management programsReferrals for social services assistanceAssistance with access to in-network providersManagement of all out-of-network medical careCoaching and encouragement for members promoting
compliance with the medical treatment planSupportive careMember and family empowermentPromotion of quality care that is also cost effective
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