Care Management

Our care managers help make health care easier for our members. They work with our members to help them understand the types of services we offer to them and how to participate in their own care.

Your patients may already be working with one of our care managers. If not, or if they need help contacting their care manager, please have them call Member Services .

Our care managers may call our members when:

• You or the member think care management might help the member.
• Following a hospital stay, members need help with follow-up visits to other doctors.
• Members are using the emergency room (ER) often for non-urgent care that could be handled by less intensive levels of care, including their primary care home.
• Members call our 24/7 NurseLine and need more follow-up for ongoing care.
• Members are experiencing serious physical or mental health problems and need more help managing their health.

Care managers can also help:

• Set up health care services for the member.
• Find referrals and prior authorizations.
• Check a member’s plan of care.

From time to time, members may have questions about calls they receive from one of our care managers. When we call, a nurse or social worker will:

• Always identify themselves with their name, title, and position with Healthy Blue.
• Tell the member about the services we offer.
• Talk to the member about their health and their current life challenges.