Enhanced Care Management

Program Objectives

Reduce unnecessary utilization by addressing clinical and behavioral needs, supporting marginalized communities, and linking them to community resources.

Key Features of Our Enhanced Care Services

Resource Connection

Assistance with housing, food and other benefits

Transportation Help

Help with scheduling medical transportation

Appointment Assistance

Help with finding a provider and scheduling appointments

HEDIS Care Gaps

Collaborate with Health Plan and PCP to close care gaps

Medication Management

Better understand your prescriptions

Community Health Workers

Connection to community supports and programs

Hospital Follow-up

Outreach within 72 hours and follow-up appointments

Weekly Nurse Follow-up

Monitor progress towards care goals and assess abnormalities

Care Team
  • Lead Care Manager
  • Community Health Worker
  • Clinical RN
Outreach & Engagement
Face-to-Face
Telephone
SMS
Mail
Email
Eligiblity Criteria
  • Current Managed Medi-Cal Members
  • Adults with High Utilizers
  • Adults with SMI/SUD and BH
  • Adults at-risk for long term care
Contact information

Health Plan Partners