Case Management Programs
Case Management (CM) Programs at CCHP ensure that medically necessary care is delivered to our members in the most efficient and effective setting and that psychosocial barriers to receiving care are addressed quickly to minimize their negative impact. CCHP offers five types of case management programs:
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Care Coordination Program
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Transitional Care Services (TCS) Program
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Complex Case Management (CCM) Program
Care Coordination Program
Care Coordination Program provides services to members who needs assistance navigating healthcare and accessing services and focuses on building natural support networks that improve independence and wellness allowing for eventual program discharge.
Interventions include, but not limited to:
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Navigation of the health care system, including, but not limited to, making appointments and reminders, finding needed service providers.
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Coordination of health care services and social services affecting health.
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Connection to available community resources that impacts their health, including public benefit programs.
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Referrals to appropriate services and support programs.
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Connection to perinatal services (Baby Watch Program)
Transitional Care Services (TCS)
Transitional Care Services provides services to members who are transitioning from one setting or level of care to another, including, but not limited to: discharges from hospitals, institutions, other acute care facilities, and skilled nursing facilities (SNFs) to home or community-based settings, Community Support placements, post-acute care facilities, or long-term care (LTC) settings.
Interventions include, but not limited to:
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Discharge plan/summary review with the member
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Medication reconciliation
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Coordination and follow up of services as outlined in the discharge summary
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Coordination with discharging facilities to support discharge plans and help address any barriers to discharge, if any
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Collaboration with other members of the member’s care team
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Screening and referral to appropriate ongoing case management program
Complex Case Management (CCM) Program
Complex case management is the coordination of care and services provided to members who have experienced a critical event or diagnosis that requires the extensive use of resources and who need help navigating the system to facilitate appropriate delivery of care and services.
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Comprehensive assessment of needs and condition, available benefits, and resources
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Development and implementation of an individualized, and member-centric care plans.
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Navigation of the health care system, including, but not limited to, making appointments and reminders, finding needed service providers.
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Coordination of health care services and social services affecting health.
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Connection to available community resources that impacts their health, including public benefit programs.
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Referrals to appropriate services and support programs.
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Transitional Care Services (if already enrolled in CCM)
Since complex case management is considered an opt-out program, all eligible members have the right to participate or decline participation.
How to Request for Case Management Services:
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Complete a CCHP Case Management referral on Epic (for CCH providers) or ccLink Provider Portal (for non-CCH providers) or
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Calling CCHP Case Management at 925-313-6887 (TTY 711) and requesting case management services or
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Faxing a completed referral form at 925-252-2609