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, Humana – CareSource and our providers can make it easier for members to manage their care. If you know of a Humana – CareSource member who may benefit from the Care Management program, please call us at 1-855-852-7005 (TTY for the hearing impaired: 1-800-648-6056 or 711).
Disease Management Program
Members with chronic conditions, including asthma and diabetes, will be automatically enrolled into the enhanced Disease Management program.
Members enrolled in the program will receive free information to help them better manage their asthma or diabetes. Information sent to members will include care options for them to discuss with their 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 or diabetes who you believe would benefit from this program and is not already enrolled, call us at 1-866-206-0272.
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.