Case management

 

Case managers work with our members to help them to better understand the types of services we offer to them and how to participate in addressing their own care.

Addressing physical and behavioral health

 

Our case managers help make healthcare easier and less overwhelming for our members through our digital services like Concierge Care, focus on improving physical health, and promoting behavioral health.

 

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.

 

 

Concierge Care areas of focus

 

The app offers a wide variety of programs for members with focused program areas that include:

  • Heart failure
  • Diabetes
  • Behavioral health including anxiety and depression
  • Maternity
  • Discharge essentials

 

 

Concierge Care features

 

The Concierge Care member-facing app features:

  • Personalized care plans
  • Medication reminders
  • Self-directed health activities like practicing mindfulness and breathing exercises
  • On-demand conversations with care managers
  • An expansive health resource library
  • Health data and symptom trackers
  • Gamified engagement to help keep members motivated on their path to better health
  • Holistic support for physical and behavioral health
  • Integration with FitBit and Apple Watch step counters

 

 

 

Case manager responsibilities

 

Our case managers may call our members if:

 

  • They or you, their healthcare provider, think case management might help the member
  • They’ve just gotten out of the hospital and need help with follow-up visits to other doctors
  • They’re going to the emergency room (ER) often for nonurgent care that could be handled by you, their healthcare provider
  • They call our 24-hour Nurse Help Line 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
  • Getting referrals and prior authorizations
  • Checking a member’s plan of care

 

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

 

 

 

Case management resources

 

Coming soon!

Interested in becoming a provider in the Wellpoint network?

 

We look forward to working with you to provide quality service for our members.

 

Join our network