Common use of Clinical Care Manager Clause in Contracts

Clinical Care Manager. a licensed Registered Nurse or other individual, employed by the Contractor or an Enrollee’s PCP and licensed to provide clinical care management, including intensive monitoring, follow-up, and care coordination, clinical management of high-risk Enrollees, as further specified by EOHHS. Clinical Criteria – criteria used to determine the most clinically appropriate and necessary level of care and intensity of services to ensure the provision of Medically Necessary services.