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Case Management

Medical case management s a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals.

It refers to the planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case management may include, but is not limited to, care assessment, including personal interview with the injured employee, and assistance in developing, implementing and coordinating a medical care plan with health care providers, as well as the employee and his/her family and evaluation of treatment results.

Medical case management requires the evaluation of a medical condition, developing and implementing a plan of care, coordinating medical resources, communicated healthcare needs to the individual, monitors an individual’s progress and promotes cost-effective care.
 
Proliance Guiding Principles
Leadership: “The essential quality for leadership is not perfection, but credibility.”
Provide “Choice”
Full disclosure in advance—”know the deal”
Consistent and predictable delivery
Constantly seeking improvement
Assess opportunities objectively and without prejudice
Active oversight of providers and distributors
After the fact due diligence
 
       
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