Case management

Make healthcare easier

Our case managers help make healthcare easier and less overwhelming 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 case managers. If not, or if they need help contacting their case manager, please have them call Member Services.

Our case managers may call our members if:

They or you, their healthcare provider, thinks case management might help the member
They have just gotten out of the hospital and need help with follow-up visits to other doctors
They are going to the emergency room (ER), often for non-urgent care that could be handled by you, their healthcare provider
They call our 24-hour Nurse HelpLine and need more follow-up for ongoing care
They have serious physical problems and need more help managing their health
They have behavioral health problems and need more help working with all of their doctors

Case managers can also help with:

Setting up healthcare services for the member
Checking a member’s plan of care
Addressing Social Determinants of Health
Assisting with Community Resources

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

Always identify themselves with their name, title, and position with Wellpoint
Tell the member about the services we offer
Talk to the member about their health and how they’re handling different parts of their life

If the member is not available, no medical information is shared on the voicemail, only the CM’s name and a return number.