Care & Disease Management

Care Management Program

Health care can be complicated, especially for members who are trying to manage complex health needs. Humana – CareSource® has nurse Care Managers who help members coordinate appropriate medical and support services for conditions such as asthma, diabetes, congestive heart failure, obesity and high-risk pregnancy.

We also provide a comprehensive, integrated Care Management model for our highest-risk members. Using nurses and social workers, this multi-disciplinary approach integrates the Case Management Society of America Standards of Practice to help patients overcome health care access barriers. Typical high-risk members may have multiple medical issues, socioeconomic challenges and behavioral health care needs.

How to Refer Members to Care Management

Together, we can make it easier for members to manage their care. If you know of a member who may benefit from the Care Management program, please call us at 1-855-852-7005.

Disease Management Program

Members with chronic conditions, including asthma, diabetes and hypertension, are enrolled automatically in the enhanced Disease Management program. If they choose not to participate in the Disease Management program, they may opt out by calling 1-844-768-2010.

Members enrolled in the program receive free information to help them better manage their condition. Information sent to members includes care options to discuss with his/her provider.

Members identified as high risk will have a nurse assigned to their case to help educate, coordinate and provide resources and tools to help the member reach their health care goals.

How to Refer Members to Disease Management Program

If you have a patient with asthma, diabetes or hypertension who you believe would benefit from this program and is not already enrolled, please call us at 1-844-768-2010.

Perinatal Care Management

Humana – CareSource’s perinatal and neonatal Care Management program uses specialized nurses, working in conjunction with providers and members, to help manage high-risk pregnancies and premature births. This program focuses on patient education and support and involves direct telephone contact with members and providers.

How to Refer Members to Perinatal Care Management

We encourage our providers to notify our Care Management department at 1-866-206-0272 when a member with a high-risk pregnancy has been identified.