Case Management
The Alliance’s case managers work with members and providers to ensure access to education, services and resources. If you have any questions about the Alliance’s case management services, please contact the Health Programs Manager at (831) 430-5595.
Long Term Care Case Manager
• Conducts Skilled Nursing Facility reviews
• Works with the Ombudsman in protecting member rights
• Acts as a community resource to providers and facilities
• Provides resources to facilities for members who are able to return home
• Assists facilities in ensuring access to appropriate care providers and resources
• Provides education to providers, members and their families so
that the processes and care provided in Skilled Nursing Facilities is understood
Medical Social Workers/Disability Liaisons
• Assist members access Alliance covered services and support services available in the community
• Help members gain access to durable medical equipment
• Serve as a point of contact for the outside agencies associated with our members
• Troubleshoot the frustrations members encounter in getting health care
• Outreach to outside agencies to exchange and share information
Children’s Case Manager
• Works with families of children with special health care needs
• Provides provider and family education
• Acts as a valuable resource to providers caring for these special needs children
• Coordinates with many community agencies such as Early Start/Infant Programs, San Andreas Regional Centers, Children’s Mental Health, School Districts Local Educational Agencies (SELPA), and Child Health and Disability Prevention (CHDP) to assure children with special needs receive the care they need
Health Programs Coordinator
• Works with area agencies promoting healthy lifestyles for our members
• Promotes Alliance benefits and refers members to local resources
• Works with members to increase appropriate prenatal visits
• Works with adolescent population to encourage well-care visits
• Works with families and providers to improve childhood immunization rates
• Coordinates health promotions to members (smoking cessation, fitness, etc.)
Chronic Disease Case Manager
• Works with members and providers to promote correct asthma medication use and decrease Emergency Room use
• Promotes Alliance health education benefits to members with diabetes and asthma
• Promotes Alliances benefits and up-to-date diabetes and asthma resources to providers
• Develops relationships with area partners to promote diabetes and asthma awareness
• Works with the Quality Improvement and Information Technology departments to target high risk members