Care Management definition

Care Management means the overall method of providing ongoing health care in which the MCO manages the provision of primary health care services with additional appropriate services provided to an Enrollee. See section 6.1.5.

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Care Management means a set of services, delivered by Care Coordinators, designed to improve the health of enrollees. Care management includes a health assessment, development of a care plan and monitoring of enrollee status, care coordination, ongoing reassessment and consultation and crisis intervention and case conferencing as needed to facilitate improved outcomes and appropriate use of health services, including moving the enrollee to a less intensive level of care management as warranted by enrollee improvement and stabilization. Effective care management includes the following:

Care Management means services that assist Enrollees in gaining access to needed services, including medical, social, educational and other services, regardless of the funding source for the services.

Examples of Care Management in a sentence

• Any entity from which the Contractor procures, re- procures, or proposes to subcontract with, for the provision of all, or part, of its Administrative Services for any program area or function that relates to the delivery or payment of Covered Services or Flexible Benefits, including, but not limited to, behavioral health, claims processing, Care Management, Utilization Management, or pharmacy benefits, including specialty pharmacy providers.

• An Enrollee’s legal guardian, family Member, or other person who has been identified in the Service Agreement with the Personal Care Management (PCM) agency that will be responsible for performing certain personal care attendant (PCA) management tasks that the Enrollee is unable to perform.

• LHD shall collaborate with out-of-county Pregnancy Management Program providers and CMHRP teams to facilitate cross-county partnerships to ensure coordination of care and appropriate Care Management assessment and services for all patients in the target population.

• LHD shall utilize assessment findings, including those conducted by the CFSP, to determine level of need for Care Management support.

• LHD shall conduct a prompt, thorough assessment by review of claims history and medical record, patient interview, case review with prenatal care provider, and other methods on all patients with one or more priority risk factors on pregnancy risk screenings and all patients directly referred for Care Management for level of need for Care Management support.

More Definitions of Care Management

Care Management means activities performed on behalf of members that include services described in rule 5160-26-03.1 of the Administrative Code.

Care Management means observation, assessment, care planning and documentation of the resident's physical, cognitive and psycho- social needs and the supervision and coordination of the services provided to meet those needs by a licensed professional nurse.

Care Management means arranging for continuity of care and coordinating the array of service necessary for treating the child; communicating with responsible individuals, and providers at least every thirty (30) calendar days to assure services are being delivered as planned and adequate progress is being made; and the authority to rescind authorization for any treatment services with proper notice.

Care Management means a type of case management in residential substance use disorder (ASAM Level 3) treatment settings that includes assessment, development of a care plan, and referral and linkage to community supports and community-based or lower level of care services to promote continued recovery after the individual discharges from the treatment facility.

Care Management means a group of activities performed to identify and manage clinical interventions or alternative treatments for identified members to reduce risk, cost, and help achieve better health outcomes. Distinct from Support Coordination, Care Management does not include the day-to-day duties of service delivery.

Care Management means the management and coordination of services to meet individual treatment needs of a client and includes:

Care Management means a type of case management in residential substance use disorder (ASAM Level 3) treatment settings that includes assessment, development of a care plan, and referral and linkage to community supports and community-based or