Care Coordination and Care Management

Neighborhood provides Care Coordination and Care Management services for individuals with complex health care needs. We know that illnesses can be frightening and difficult to manage on your own. The purpose of a Care Coordinator or Care Manager is to have one person help you with your behavioral and medical care, coordinating your services and appointments. To learn more about Care Coordination and Care Management, visit your plan page and view your member handbook or contact Member Services.

For Members with Highly Complex Needs

 

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 need help navigating the health care delivery system.

Who Might Benefit from Complex Care 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 Care 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 Care Management program, please contact Neighborhood Member Services.