Neighborhood has a case management program for members who have highly complex needs. Along with Neighborhood’s other case management programs, the Complex Case Management Services program focuses on the coordination of services, goal-setting and 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 Neonates discharged to home from a NICU or Level 2 nursery stay.
- Members who have been discharged home following an inpatient hospitalization greater than 21 days.
- Pediatric members discharged home following an acute rehabilitation or skilled nursing facility stay.
- Adult members discharged to home from an acute rehabilitation facility after a stay of seven days or more.
- Members who have been discharged to home following a transplant.
- Members taking medications with suboptimal treatment plans.
What can Neighborhood’s 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 further information about Neighborhood’s Complex Case Management programs, or to refer a member who you believe may benefit from these services, please call us directly at 1-800-459-6019.