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Case and Disease Management

What is Case Management?

The plan is committed to early identification of members who may be at risk for health care needs or services. We identify members through multiple resources which include the Health Risks Assessment, referral from your provider, utilization management team or pharmacy data. You may also self-refer yourself into our Care Management program.

Once a referral is made the Care Manager or Case Manager will perform outreach to you and your provider to create a plan of care individually tailored to you.    

Did you know Simply Healthcare Plans offers Case and Disease Management programs at no cost?  We have special programs that can help meet your needs. The following are a list of programs available:
  • Asthma
  • Behavioral Health
  • Complex Needs (Multiple Conditions)
  • Congestive Heart Failure
  • Diabetes
  • High Blood Pressure
  • Maternity (Pregnancy)
  • Oncology (Cancer)
  • Smoking Cessation
  • Special Needs (Simply Care, Simply Comfort, Simply Complete, and Simply Level)
  • Weight Management
These programs can help you meet your health goals. If you participate, a Case Manager will be assigned to you. A Case Manager is a person who helps you in assessing your needs and works with you and your doctor in making a plan to improve your health.  Your Case Manager will help you to reach your goals.
If you are interested or want to learn more, please call our Case and Disease Management Department toll free at: 1 (855) 431-1606.  
Mondays through Fridays from 8 AM to 5 PM EST. 
You do not need to call if you do not wish to participate. You can also change your mind at any time.  


Beacon is our partner in ensuring your behavioral health needs are met. For more information on Beacon, click here:

Health and Wellness

For information about diabetes, click
Last Updated: 
September 27, 2016