Care Management

What is care management?

Care management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet a member's health and human service needs. It uses advocacy, communication, and resource management. It also promotes quality and cost-effective, best practice interventions that lead to positive outcomes for each member.

Based on the needs and values of the member — and in collaboration with all service providers — care coordinators link members with appropriate providers and resources across health, human services, and care settings. They also ensure that the care provided is safe, effective, patient-centered, timely, efficient, and equitable. This approach achieves the best value and desirable outcomes for all involved in member care — including the member, their caregivers, support systems, and providers.

For more information, contact AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan) Member Services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., seven days a week.

How to get a care coordinator

A care coordinator helps you manage your medical providers and services. Contact us if you would like to get a care coordinator, contact your care coordinator, or change your care coordinator. Call 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., seven days a week. This call is free.

After regular business hours, members may obtain plan information from the interactive voice response system and may leave a message for their care coordinator. We have free interpreter services for people who do not speak English.

Contact your care coordinator about:

• Questions about your health care
• Questions about getting behavioral health services, transportation, and long-term services and supports (LTSS)
• Questions about any other supports and services you need
• LTSS benefits, which are offered to all plan enrollees, as medically necessary. If you are not a waiver participant, you can receive waiver benefits through AmeriHealth Caritas VIP Care Plus if they are medically necessary.