Common use of Case Management Strategies Clause in Contracts

Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.

Appears in 2 contracts

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)

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Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians providers and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.

Appears in 2 contracts

Samples: Provider Agreement (Molina Healthcare Inc), Provider Agreement (Wellcare Health Plans, Inc.)

Case Management Strategies. The MCP must MCPmust follow best-practice and/or evidence based clinical guidelines when devising developing a member’s care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians providers and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.

Appears in 1 contract

Samples: Provider Agreement (Wellcare Health Plans, Inc.)

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Case Management Strategies. The MCP must follow best-practice and/or evidence based clinical guidelines when devising a member’s 's care treatment plan and coordinating the case management needs. If an MCP uses a disease management methodology to identify and/or stratify members in need of case management services, the methods must be validated by scientific research and/or nationally accepted in the health care industry. The MCP must develop and implement mechanisms to educate and equip physicians and case managers with evidence-based clinical guidelines or best practice approaches to assist in providing a high level of quality of care to members.

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan Abd Eligible Population (Wellcare Health Plans, Inc.)

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