Life Events

Innovative Care Management Programs

Check out the Innovative Care Management Programs flyer.

Case Management

Complex medical conditions can be very stressful and confusing. Our Case Management program is designed to help members cope with a variety of complex conditions by working closely with them, their families, and their doctors. Each member enrolled in our Case Management Program is assigned a specific nurse to help coordinate care, help obtain specialized medical equipment, provide information, and listen to their questions and concerns. A participant in our Case Management program can expect to be treated with the highest care and respect, and receive quality services like the following:

  • Identification of Preventable Measures—our Nurse Case managers are able to identify preventative measures, such as medical equipment, medication, or alternative services, which can help members control their condition before serious complications arise.
  • Patient Advocacy—In every situation, we want members to receive the treatment they need. We make a strong effort to help members know what questions to ask their doctor, encourage communication between their care providers, and even help coordinate care so that members receive the treatment and medical equipment they need, when they need it.
  • Care Coordination—When dealing with a complex condition, a member often will receive care from a number of doctors and facilities. The Nurse Case Manager helps coordinate the care between these caregivers to ensure that the best treatment is provided.
  • Patient Stabilization—If members are experiencing serious complications or are hospitalized, their nurse will follow their progress closely, and make sure that the most appropriate care is received. The nurse will also coordinate alternative treatments such as home health, where the necessary care is provided in the comfort of the member's home, while at the same time saving on costly hospital stays.

What to Do
Most participants are referred to Case Management through the screening process of our Preauthorization and Utilization Management program, or through their benefit plan. Any member that would benefit from Case Management is then contacted by one of our nurses and asked to participate. Participants with a number of conditions are monitored in the program such as:

  • Cancer
  • Traumatic injuries
  • Transplants
  • Complex medical diagnoses
  • Organ Failure
  • High-risk pregnancy
  • Complex psychological issues
  • And more...

While most high-risk members are found through our screening, if you feel that you or a member of your family would benefit from Case Management, feel free to give us a call. Participation with our Case Management program is entirely voluntary.

Contact Innovative Care Management or your Human Resources Department to find out more about any of these programs offered to you and your family covered under your health plan.

Toll Free 800.862.3338
Portland Area 503.654.9447
Fax 503.654.8570