Understanding Complex Case Management
Using the health care system can be confusing, especially for those with many health-related needs. That is why Gundersen Health Plan offers a service called Complex Case Management. The goal of Complex Case Management is to work closely with members to coordinate healthcare services and resources to make sure you get the best care possible.
How does Complex Case Management work? A registered nurse case manager works with members who are eligible for these services. We work with you, your family, and your health care providers to make sure you receive the best care possible, in the most cost-effective way, with the best possible outcome.
The nurse helps by:
- coordinating care between health care providers (when you see more than one doctor)
- assisting you in identifying your personal health goals
- understanding your health care benefits
- providing education about your condition and your care
- finding support groups or programs that may be helpful
Who is Eligible? Gundersen Health Plan members who:
- have high risk medical conditions
- need to learn how to care for themselves and their medical condition
- have had many hospital visits
- have had many falls causing an injury
- have more than one serious health problem
- have complex medical needs