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

My representative was wonderful. I didn’t even know this service existed. It’s nice to know when you’re recovering from surgery and unable to make all of the calls needed, someone can be your advocate. The nurse took all of the worry from my shoulders.

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.

This was my first experience with a Workers’ Comp situation. The coordination and communication on your part was excellent. [My CCM Nurse] was an excellent source of information and very helpful while I was out of work and after returning to work. I was able to rely on her for any follow up needed. She also offered to forward emails as I was not able to logon to my computer (went ABOVE and beyond expectations).

My nurse was always very concerned with my well being and health and stayed in touch on a regular basis to see if I needed anything extra.

An [Intake Coordinator] assisted today in getting a surgery authorized for us for a patient who is scheduled for surgery next Tuesday. She was very helpful and very professional.

[My CCM Nurse] understands that I want to work, but I cannot work while in pain. She has done a great job getting me the needed treatments so I can continue to work!

The CCM Intake Coordinator was a great pleasure to work with. She was quick and efficient and held a decent conversation with me as we worked through getting prior authorization. She is a great individual to work with.

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.

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.