Health Plan Management

Health Plan Management Services

At CCM, we provide a data-driven and member-centric approach to care management.

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Health Utilization Management

CCM performs medical necessity reviews using evidence based clinical criteria.

Prospective Reviews
Concurrent Reviews
Retrospective Reviews
Appeals

Case Management & Care Coordination

CCM nurses reach out to members having high cost or complex medical conditions to help them coordinate care and act as member advocates, guiding patients and families through the complex healthcare system.

Medical Plan Reviews

We meet regularly with our clients to help them understand their cost drivers and how best to design and implement effective programs for their members.

Get in touch with CCM today!

This is the best thing for people who do not understand insurance. I love this program. -Health Plan Family Member

The wellness nurse has been in touch with me regarding various recommendations for my health over the past few years and guided me through the maze of assisting me in finding doctors that were covered by my insurance to take care of my health. I appreciate her efforts.

This program is valuable and the nurse was helpful. I can understand the importance of following up with my diabetes.

I work frequently (nearly every day of the week) with the representatives of CCM and it is always a great, easy, and quick call. They are always friendly and help with anything I request, even when it is multiple patients. Job well done, they are fantastic!

The help we received was exceptional. We were both very grateful to have someone to reach out to in our time of need and our CCM nurse was the best. Thank you!!

I called for some authorization information and spoke with a CCM representative. When I hung up the phone, I said to my co-workers, that person was seriously the nicest lady ever to work with. Why can’t everyone be like her! Thank you for being so helpful and friendly.

The nurse I had is an asset to the Corporate Care Management team. She is an efficient communicator, expert in resolving and identifying management of our daughter’s illness and a skilled listener.

My CCM nurse was amazing helping me. She responded in a professional and timely fashion. Every time I spoke with her she was very pleasant and helpful with every question.

My CCM nurse has been awesome in the help and concerns for my son and his healthcare and issues we have had. I can’t thank her enough for the prompt responses.

From a Provider: [My CCM Nurse] was absolutely wonderful, kind, professional and efficient. I would work with her at any point during my career. Thank you.