Care Management System. The Contractor’s Care Coordinators will use the Care Management system to review assessments, interventions, and management of Chronic Health Conditions to gather information to support Enrollee Care Plans and identification of Enrollees’ needs. No later than twelve (12) months after the first enrollment, the Contractor shall update the Care Management system to extend its functionality to provide Enrollees and Providers with web-based access to the Contractor’s Care Management system.
Care Management System. The ICDS Plan must have a Care Management system that captures, at a minimum, for each Beneficiary the results of the assessment, the ICP content, including goals, interventions, outcomes and completion dates, and Beneficiary/provider contact notes. This system must be linked to other databases, systems, and the centralized enrollee record that the ICDS Plan uses to maintain information about the Beneficiary. The goal is to integrate the Beneficiary information in a meaningful way to facilitate Care Management needs. The system(s) must have the capability to share Care Management information with the Beneficiary and any member of the Trans-Disciplinary Care Team, as appropriate.
Care Management System. Contractor’s Care Coordinators will use the Care Management system to review assessments, interventions, and management of Chronic Health Conditions to gather information to support IPoCs and identification of Enrollees’ needs. Contractor shall have fully operational portals which provide Enrollees and Providers access to relevant information from the care management system.
Care Management System. As part of the Care Management System, the Contractor shall employ care coordinators and case managers to arrange, assure delivery of, monitor and evaluate basic and comprehensive care, treatment and services to a Member. Members needing Care Management Services shall be identified through the health risk assessment, evaluation of Claims data, Physician referral or other mechanisms that may be utilized by the Contractor. The Contractor shall develop guidelines for Care Coordination that will be submitted to the Department for review and approval. The Contractor shall have approval from the Department for any subsequent changes prior to implementation of such changes subject to Section 4.4 “Approval of Department.” Care coordination shall be linked to other Contractor systems, such as QI, Member Services and Grievances.
Care Management System. As part of the Care Management System, the Contractor shall employ care coordinators and case managers to arrange, assure delivery of, monitor and evaluate basic and comprehensive care, treatment and services to a Member. Members needing Care Management Services shall be identified through the health risk assessment, evaluation of Claims data, Physician referral or other mechanisms that may be utilized by the Contractor. The Contractor shall develop guidelines for Care Coordination that will be submitted to the Department for
Care Management System. Management system to review assessments, interventions, and management of Chronic Health Conditions to gather information to support IPoCs and identification of Enrollee Contractor shall have fully operational portals, which provide Enrollees, Providers, DCFS Guardianship Administator, DCFS Authorized Agents, and DCFS Caseworkers access to relevant information from the Care Management system. Contractor shall also have the capability of utilizing secure email to provide the DCFS Guardianship Administrator, DCFS Authorized Agents, and DCFS Caseworkers with relevant information from the Care Management system.
