Published September 2019
Life is often unpredictable for you, your company, and your employees. When health challenges arise, some insurance companies treat their members like they’re all the same. But we know that each member of your team has their own unique health care needs. That’s why we offer comprehensive support and empowerment for many medical conditions with our nurse care managers.
The Nurse Care Manager Program
Nurse care managers partner with your qualified employees to manage treatment of their existing conditions, and guide them through the complex health care system by planning, implementing, coordinating, monitoring, and evaluating the health care options and services available to your employees. If your employees qualify for the program, they’ll get access to our Care Management app, helping them stay connected to their Nurse Care Manager guide no matter where they are.
"Nurse care managers partner with your qualified employees to manage treatment of their existing conditions, and guide them through the complex health care system."
Knowing If Your Employees Qualify
Our care management team uses several methods to determine which members may benefit most from our services, such as:
- High-cost claims analysis
- Hospital discharge review processes
- Predictive modeling
- Self-referral or physician referral
When we identify an employee who may benefit from care management, one of our nurses reaches out to them directly. The nurse care manager works with your employee to address their specific health needs, no matter what challenges they face.
Benefits to You
Our nurse care managers don’t just help your employees find treatment options. We work with each member, other health care resources, and primary care providers to offer your workforce specialized support services, including:
- Assessment of their health care needs
- Coordination of their health care services
- Development of a health care plan, including education and disease prevention strategies, that’s customized to their needs
- Help putting the plan into action and monitoring members to ensure success
- Helping members find the highest quality care available in a location that’s best suited to them
Special Programs and Services
Many of our nurses receive special training to provide specific services to members with complex health needs. With programs to help employees avoid hospitalization, we help your team stay as healthy as possible. Depending on your company’s insurance offerings, your employees may have access to other special programs and services, including:
- Chronic kidney disease program
- Health coach program
- Medical social work services
- Oncology (cancer) care management
- Rare disease management
Watch the video below to see how these member-centric benefits helped one individual navigate his complex health care journey:
We believe that each of our members deserves the most inclusive, personalized care we can provide. No matter what your employees need, we help your workforce achieve their health care goals while staying as healthy as possible. Please call us at (866) 750-2068 or talk to your broker to learn more about program eligibility.
To confirm eligibility for any programs or services mentioned in this article as it relates to your specific health plan, please reach out to your account executive or HR benefits team. You may also speak to our member services team at (888)-333-4742 or by sending a secure email. And for plan details and other member resources, log in to the member portal.