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Care management

The BCBSND Care Management program is designed to help members navigate their healthcare journey with personalized support. Through collaboration with a registered nurse, members receive guidance in understanding care options, managing chronic or complex conditions, and working toward improved health and daily functioning. This service is offered at no additional cost to members.

Care coordinators—registered nurses —recognize the emotional impacts of serious illness and are trained in:

  • Motivational interviewing
  • Crucial conversations
  • Care coordination

Assessments

Care management often includes voluntary assessments including:

  • Comprehensive health screening
  • Screening for depression and anxiety
  • Assessment of Member’s Health Engagement
  • Medication reconciliation

Interventions

Care coordination interventions include:

  • Goal setting with members to achieve optimal health outcomes
  • Motivational interviewing to assess barriers to change
  • Assessment of member engagement into their health
  • Providing education regarding health risks and needs assessment
  • Collaboration/referral to Patient Centered Medical Home/primary care provider
  • Transition of care planning for complex cases
  • Coordination of local, regional and nationwide health care services
  • Ongoing care management for especially complex and chronic cases
  • Referrals to disease management professionals for rare and complex disease management
  • Assisting members in making informed health care decisions
  • Connecting the members to the right resources within BCBSND to help them understand their benefits

Care management referrals

A member or their authorized representative must consent and agree to participate in the care management program. Enrollment is voluntary, at no additional cost to the member.

Care management referrals can be initiated by:

  • The member/patient
  • The member's authorized representative
  • A health care provider

To initiate a referral to care management, contact BCBSND at 800-336-2488.

Medicaid Expansion

For information about Medicaid Expansion Care Management visit here.