For Members with Highly Complex Needs
Similar to Neighborhood’s other case management programs, this program focuses on the coordination of services and goal-setting/treatment for members who have experienced a critical event or diagnosis that requires the extensive use of resources and who need help navigating the health care delivery system.
Who Might Benefit from Complex Case Management Services?
- High Risk Newborns discharged to home from a Level II nursery
- Individuals with an Inpatient stay greater than 21 days
- Individuals discharged from an acute rehabilitation or skilled nursing facility
- Individuals who have been discharged to home after having a transplant
- Individuals taking multiple medications with complicated treatment plans
What can the Neighborhood Complex Case Managers do for members?
- Support and reinforce members in their efforts to adhere to treatment interventions recommended by their health care providers.
- Advocate for members to obtain the most appropriate health care services available.
- Act as a liaison between all providers to enhance communication
- Educate members, families and health care providers regarding benefits, availability of services, community resources and health care alternatives
- Reduce barriers in order to maximize positive member outcomes
For more information or to make a referral to Neighborhood’s Case Management program, please call Neighborhood Customer Service at 1-800-459-6019.