Case Management

Cost-effectively coordinate the care of your members most in need

Easily coordinate the care of your most complex patients, reducing costs while improving outcomes. This module seamlessly operates with the Disease and Utilization Management solutions, creating one platform for your entire membership.

Assessment and Referral Management
Assessment & referral management – Easily and consistently identify members for management by leveraging all existing referral channels and consumer data, from both in-house and external sources. Use structured branching assessments to determine which programs and resources your members would most benefit from.
Care Planning
Care planning – Use the template-based care planning module to effectively address all conditions and co-morbidities. Give clinical users the ability to modify care plans based on the specific needs of members, while simultaneously driving program consistency. Automatically monitor ongoing adherence to care plans to more easily identify gaps in care or deviations from protocol.
Task Management
Task management – Give each user a single, prioritized view of their required activities. Tasks are automatically populated from the member’s care plan, from other users, and from users themselves. Route missed-tasks and gaps-in-care to super-users per your standard operating procedures, while supporting task sharing and cooperative management models.
Documentation and Letter Generation
Documentation & letter generation – Streamline the creation of accurate, comprehensive internally- and externally-oriented documentation with template-based forms and letters.
Mobile Support
Mobile support – Fully support mobile and field-based care management team who utilize either a standard laptop computer or tablet PC.
Third Party Integration
Third party integration – Exchange data in real-time and via batch processes with eligibility, claims, pharmacy, predictive modeling and lab systems, creating a true payer-based personal health summary.