Neighborhood provides care coordination and care management services for members with complex health care needs. We know that getting sick can be scary sometimes and hard to manage on your own. A Neighborhood Care Coordinator or Care Manager is someone who can help you with your medical care, behavioral health concerns, and can coordinate your services and appointments.
To learn more about care coordination and care management, visit your plan page and view your member handbook or contact Neighborhood Member Services.
For Members with Highly Complex Needs
Complex Care Management focuses on the coordination of services, treatment, and goal-setting for members who have experienced a critical event or have received a diagnosis that requires an extensive use of resources and need help navigating the health care delivery system.
Who Can Benefit from Complex Care Management Services?
- High-risk newborns who are discharged to their 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 the member and their providers to help with communication
- Educate members, families, and health care providers about 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 Member Services at the phone number listed on the back of your Neighborhood ID card.
Care Coordination
For members who need help coordinating their health care needs
Neighborhood Community Health workers lead this patient-and family-centered, team-based approach for helping members organize and navigate care activities.
Case Management
For Members with chronic or complex health conditions
Neighborhood Case Managers provide oversight of a member’s health care needs to improve their overall well-being. A case manager is a nurse, social worker, or other health care professional. They work with you, your family or caregiver, and providers to make sure you get the care you need.
What can the Neighborhood Community Health Workers and Care Managers do for members?
- Connect to resources in your community
- Better understand your chronic conditions and medications
- Work with your providers to make a plan of care that meets your needs
- Overcome barriers to getting the care you need
- Find community supports and services to keep you as independent as possible
For more information or to make a referral to Neighborhood’s Care Management program, please contact Member Services at the phone number listed on the back of your Neighborhood ID card.
Neighborhood has a number of clinical programs and educational resources for members to help manage their health concerns. Please visit Clinical Programs & Educational Materials – NHPRI.org to learn more.
Neighborhood has created a list of helpful, local resources for members to quickly find services that support health, wellness, and daily living needs, such as transportation, food assistance, housing support, and community programs.
The Neighborhood Community Resources document is a centralized guide to trusted community organizations, making it easy for members and their care teams to connect with available resources close to home.
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