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!

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!

[CCM] really helped me learn it was okay to ask questions and be my own advocate.

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.

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.

“This was a last minute situation for a patient. The intake coordinator handled it very, very well. I couldn’t have been more pleased. She made sure to get it done before the end of the year so they could get the supplies under their policy because they reached the deductible.”

I enjoy being able to speak with your Registered Nurse about my progress with Diabetes and my frustrations.

My CCM Nurse…is very professional and caring. She cares just like a family member. [She is] easy to talk to, asks and answers questions very professionally [and] she even shared a few tears with me.

I’d like to say my CCM nurse was very helpful in getting a STAT MRI approved for me, and this was the fastest approval I have ever gotten.

I have had the “sugar” for 10 years, my Dad had it and my son has it. I like having a nurse available to me so that I am able to call her if I have questions regarding my health. Her name and number is taped to my refrigerator. It’s a good benefit to have.

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.