Care Coordination Xxxxx 0 and Level 3 Sample Clauses

Care Coordination Xxxxx 0 and Level 3. For Members meeting one of the indicators below, the CONTRACTOR shall conduct a Comprehensive Needs Assessment (further explained in Section 4.4.5 of this Agreement) to determine whether the Member should be in care coordination level 2 or level 3: 4.4.3.5.1 Is a high-cost user as defined by the CONTRACTOR; 4.4.3.5.2 Is in out-of-State medical placements; 4.4.3.5.3 Is a dependent child in out-of-home placements; 4.4.3.5.4 Is a transplant patient; 4.4.3.5.5 Is identified as having a high risk pregnancy; 4.4.3.5.5.1 Pregnant members 18 years of age and younger 4.4.3.5.6 Has a Behavioral Health diagnosis including substance abuse that adversely affects the Member’s life; 4.4.3.5.7 Is medically fragile; 4.4.3.5.8 Is designated as ICF/MR/DD; 4.4.3.5.9 Has frequent emergency room use, defined as two (2) or more emergency room visits in a six (6) month period; 4.4.3.5.10 Has an acute or terminal disease; 4.4.3.5.11 Is readmitted to the hospital within thirty (30) Calendar Days of discharge; 4.4.3.5.12 Has other indicators as prior approved by HSD; and/or 4.4.3.5.13 Is a Medically Frail Adult Member
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Care Coordination Xxxxx 0 and Level 3. For Members meeting one of the indicators below, the CONTRACTOR shall conduct a comprehensive needs assessment (further explained in Section 4.4.5 of this Agreement) to determine whether the Member should be in care coordination level 2 or level 3: 4.4.3.5.1 Is a high-cost user as defined by the CONTRACTOR; 4.4.3.5.2 Is in out-of-State medical placements; 4.4.3.5.3 Is a dependent child in out-of-home placements; 4.4.3.5.4 Is a transplant patient; 4.4.3.5.5 Is identified as having a high risk pregnancy; 4.4.3.5.6 Has a Behavioral Health diagnosis including substance abuse that adversely affects the Member’s life; 4.4.3.5.7 Is medically fragile; 4.4.3.5.8 Is designated as ICF/MR/DD; 4.4.3.5.9 Has high emergency room use as defined by the CONTRACTOR; 4.4.3.5.10 Has an acute or terminal disease; 4.4.3.5.11 Is readmitted to the hospital within thirty (30) Calendar Days of discharge.; 4.4.3.5.12 Has other indicators as prior approved by HSD; and/or 4.4.3.5.13 Is Medically Frail.
Sample 1

Related to Care Coordination Xxxxx 0 and Level 3

  • Care Coordination The Parties’ subcontract shall require that the Enrollee’s CP Care Coordinator provide ongoing care coordination support to the Enrollee in coordination with the Enrollee’s PCP and other providers as set forth in Section 2.6.

  • Project Management and Coordination The Engineer shall coordinate all subconsultant activity to include quality of and consistency of work and administration of the invoices and monthly progress reports. The Engineer shall coordinate with necessary local entities.

  • Order Coordination and Order Coordination-Time Specific 2.1.9.1 “Order Coordination” (OC) allows BellSouth and Lightyear to coordinate the installation of the SL2 Loops, Unbundled Digital Loops (UDL) and other Loops where OC may be purchased as an option, to Lightyear’s facilities to limit end user service outage. OC is available when the Loop is provisioned over an existing circuit that is currently providing service to the end user. OC for physical conversions will be scheduled at BellSouth’s discretion during normal working hours on the committed due date. OC shall be provided in accordance with the chart set forth below. 2.1.9.2 “Order Coordination – Time Specific” (OC-TS) allows Lightyear to order a specific time for OC to take place. BellSouth will make every effort to accommodate Lightyear’s specific conversion time request. However, BellSouth reserves the right to negotiate with Lightyear a conversion time based on load and appointment control when necessary. This OC-TS is a chargeable option for all Loops except Unbundled Copper Loops (UCL) and Universal Digital Channel (UDC), and is billed in addition to the OC charge. Lightyear may specify a time between 9:00 a.m. and 4:00 p.m. (location time) Monday through Friday (excluding holidays). If Lightyear specifies a time outside this window, or selects a time or quantity of Loops that requires BellSouth technicians to work outside normal work hours, overtime charges will apply in addition to the OC and OC-TS charges. Overtime charges will be applied based on the amount of overtime worked and in accordance with the rates established in the Access Services Tariff, Section E13.2, for each state. The OC-TS charges for an order due on the same day at the same location will be applied on a per Local Service Request (LSR) basis.

  • Service Coordinators Each Party has designated an employee or title as the key contact for the day-to-day implementation or monitoring of each Service as specified in the applicable Transition Service Schedule (each, a “Service Coordinator”). The Parties shall direct communications relating to specific Services to the applicable Service Coordinators. The Service Coordinators shall report to the Transition Committee from time to time, as directed by the members of the Transition Committee designated by the applicable Party.

  • Cooperation and Coordination The Parties acknowledge and agree that it is their mutual objective and intent to minimize, to the extent feasible and legal, taxes payable with respect to their collaborative efforts under this Agreement and that they shall use all commercially reasonable efforts to cooperate and coordinate with each other to achieve such objective.

  • Management Grievance The Employer may initiate a grievance at Step 3 of the grievance procedure by the Employer or designate presenting the grievance to the President of the Union or designate. Time limits and process are identical to a union grievance.

  • Program Management 1.1.01 Implement and operate an Immunization Program as a Responsible Entity 1.1.02 Identify at least one individual to act as the program contact in the following areas: 1. Immunization Program Manager;

  • Project Coordination The Engineer shall coordinate all subconsultant activity to include quality and consistency of deliverables and administration of the invoices and monthly progress reports. The Engineer shall coordinate with necessary local entities.

  • Project Management Plan 3.2.1 Developer is responsible for all quality assurance and quality control activities necessary to manage the Work, including the Utility Adjustment Work. Developer shall undertake all aspects of quality assurance and quality control for the Project and Work in accordance with the approved Project Management Plan, Good Industry Practice and applicable Law. 3.2.2 Developer shall develop the Project Management Plan and its component parts, plans and other documentation in accordance with the requirements set forth in Section 1.5.2.5

  • Project Management Project Management Institute (PMI) certified project manager executing any or all of the following: • Development of Project Charter • Development of project plan and schedule • Coordination and scheduling of project activities across customer and functional areas • Consultation on operational and infrastructure requirements, standards and configurations • Facilitate project status meetings • Timely project status reporting • Address project issues with functional areas and management • Escalation of significant issues to customers and executive management • Manage project scope and deliverable requirements • Document changes to project scope and schedule • Facilitate and document project closeout

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