What a Case Manager Provides to Members

Last update: October 2, 2020

The UnitedHealthcare Community Plan Case Management program is a holistic approach to care for members with complex needs, especially for those with chronic conditions. The goal is to keep our members in the community with the resources necessary to maintain the highest functional status possible.

Here’s what a case manager can provide to your members:

  • Telephone contact with members and home visits as needed
  • Disease management programs
  • Health education and educational materials
  • A health assessment with stratification of diagnosis and severity of condition and psychosocial needs
  • Referral to community resources as needed
  • Assistance with medical transportation
  • Arrangements for Durable Medical Equipment (DME) and ancillary services as needed or ordered by the physician
  • Outreach to members to promote assistance with keeping doctor’s appointments
  • Work with members to identify and address barriers to seeking health care and following their medical treatment plan of care

Areas of case manager expertise available to providers:

  • Disease  management programs
    • Diabetes
    • Congestive  heart  failure
    • Asthma
    • HIV
    • Chronic Obstructive Pulmonary Disease
    • Sickle cell anemia
  • Special Needs Case Management
  • Complex Needs Case Management
  • Pediatrics/neonatal intensive care unit (NICU) Case Management
  • Emergency Room Utilization Case Management
  • Healthy First Steps Program for pregnant women; member does not have to be high risk to receive this service. Call: 800-599-5985, TTY 711, 8 a.m. – 7 p.m. Eastern Time, Monday – Friday

You may refer high-risk members or any member who asks for case management services to the Special Needs Unit for help. Special Needs Unit: 800-460-5689, TTY 711