Priority Health supports members with complex and/or serious health issues with an in-house team of more than 70 advance-practice nurses, doctors, pharmacists and certified case managers. You get individualized
care to ensure you get back to health faster.
We'll start case management either by physician referral or if a member:
- Self-refers
- Has more than one disease or acute condition (comorbidities)
- Accrues high-dollar claims (we typically intervene at much lower levels than other insurers so you get help earlier)
- Seeks inpatient or emergency room care
- Is taking more medications than are actually needed (polypharmacy - see definition)
If you have a complex or serious health condition, we offer:
- Educational information about specific conditions, including links to online tools, condition support groups and more
- Speak directly with one of our nurse case managers - request a call
- Clinical pharmacy management that ensures members are taking the best medications for their conditions
- Care coordination and advocacy to help members navigate the health care system
- Success stories about how we've helped members receive the best health care possible
On-staff experts
Priority Health's on-staff case managers' certifications include:
- Advanced Cardiac Life Support
- Asthma Educator
- Advanced Pediatric Life Support
- Childbirth Educator
- Case Manager
- Diabetes Educator
- Life Care Planning
- Managed Care Nurse
- Professional in Health Care Quality
- Professional in Utilization Management
- Professional in Utilization Review
- End of Life Nursing Education
- Legal Nurse Consultant
- Geriatric Resource Nurse
Last modified
12/29/09
