Tiered Case Management Based on Need Sample Clauses

Tiered Case Management Based on Need. The Contractor shall implement a tiered case management program that provides for differing levels of case management based on an individual enrollee’s needs. The Contractor shall engage enrollees, or their parent or legal guardian, as appropriate, in a level of case management commensurate with their risk score as identified through predictive modeling combined with the care needs identified in the enrollee’s plan of care and HNA, as described below. Where the enrollee’s PCP or behavioral health provider offers case management, the Contractor shall support the provider as the lead case manager on the multi-disciplinary care team. The Contractor shall have three (3) levels of case management and transitional case management for individuals as they move between care settings.
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Related to Tiered Case Management Based on Need

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