Care Management
Oklahoma Complete Health Care Management teams are available to assist members with medical, behavioral or social complex needs that may benefit from increased coordination of services to optimize health and prevent disease. Our Care Management Department is staffed by individuals with extensive medical and social work experience in areas such as obstetrics, oncology, behavioral health, medical/surgical, and physical rehabilitation for children and adults.
Early intervention is essential to maximize treatment options while minimizing potential complications associated with catastrophic illnesses or injury and exacerbation of chronic conditions. A Care Manager is available Monday through Friday, from 8 a.m. to 5 p.m. CDT to assist with coordination of the members’ healthcare needs.
The following conditions, circumstances and/or diagnoses are examples of appropriate referrals to the Care Management Department:
- Adults or children with Serious or Complex Medical Needs
- Adults or children who screen positive for a behavioral health need
- Social Issues (food, housing, transportation, employment, social isolation, domestic violence)
- Asthma
- Diabetes
- High Blood Pressure
- Heart Problems
- COPD
- Anxiety
- Depression
- ADHD
- Substance Abuse
- Severe and Persistent Mental Illness
- High Utilization
- Frequent missed appointments
- Non-compliance with care plan
The provider’s role in Oklahoma Complete Health Care Management program is extremely important. Practitioners who have identified a member who they think would benefit from disease or case management should contact the Care Coordination Department to speak with a member of our Integrated Care Team at 1-833-752-1664.