UMR’s Case Management services identify catastrophic and complex cases and help
coordinate cost-efficient health care services.
The UMR Case Management program is URAC-accredited to meet recognized industry
standards.
Our nurse case manager work with the member, family, and health care providers and
facilities, as well as other health care services, vendors or support groups, to coordinate a
caring treatment plan that uses the member’s plan benefit dollars as efficiently as possible. For
example, UMR nurse case managers can expedite a member’s move from a costly inpatient setting to
the most appropriate alternate setting.
Once UMR identifies high-risk cases, we match the level and method of case
management services to the patient’s particular care needs. The nurse case manager helps the
member and family coordinate and negotiate quality treatment all the way through to
recovery.
Case Management services include:
-
Assessment of complex and catastrophic cases
-
Coordination with complex treatment plans
-
Specialty teams for transplants, high-risk pregnancy, neonatal intensive care,
behavioral health and cancer