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Care Management

Care Management

Some members have special needs. Nebraska Total Care offers one-on-one help for members with a specific health concern. Care Management gives support to members who need extra help to be as healthy as possible. These services can be:

  • Education about lifestyle changes
  • Home care
  • Community resources
  • Coordination with your medical providers

Should You Be in Care Management?

We can help with health needs or life circumstances that are hard to manage. Sometimes this is called “medically complex.” Some examples are:

  • A serious medical diagnosis
  • More than one medical diagnosis
  • A substance use disorder
  • Behavioral health needs
  • A disability that makes it hard for you to do daily tasks
  • A condition that put you on Social Security
  • Children with special needs
  • Children in the foster care system
  • Children aging out of the foster care system
  • Children with special needs aging into adult care
  • Being homeless, or at risk for homelessness
  • Transitioning from incarceration into the community
  • Being unable to meet your basic needs.

If you have these or other risks, we can help you. Use any of these ways to tell us if you need more help:

What Is a Care Manager?

A Care Manager is a personal wellness coach. They work closely with you to plan your health goals. They help you figure out the steps to achieve your goals.

Our Care Management team includes:

  • Registered Nurses (RN)
  • Social Workers
  • Licensed behavioral health clinicians (counselors)
  • Community Health Workers

Your Care Manager will work with you and your providers to help you get the care you need. Together, you will develop your individualized plan of care. Sometimes they can arrange treatment that is not typical for most people. They may work with our Medical Director to authorize additional care when:

  • A member has a severe condition and treatment will probably take a long time
  • There are alternative services that can be used instead of covered services that are more expensive.
  • More services than usual are necessary.
  • Other non-medical supports are needed. This could be things like food and housing.

Nebraska Total Care also has a digital Care Management tool. This is a free app for your phone. It lets you:

  • View articles and videos to help you understand your health.
  • Take surveys to help your care team give you the best possible support.
  • Message directly with your care team to ask them any questions about your health or care.

If you would like to use this app please call Member Services. The phone number is 1-844-385-2192 (TTY 711).

Nebraska Total Care has the right to stop an alternative care plan. We can stop the plan if it is no longer appropriate or it does not work. You would get a letter and be told at least 10 days before a care plan is stopped.

Accessing Care Management

If you think you could benefit from Care Management, please call us. The number is 1-844-385-2192 (TTY 711). We will help you find the right resources for your needs. Providers, hospital staff, or others may recommend you for Care Management services. If that happens our staff will contact you.

Care Management is never required. You do not have to participate. If you start Care Management and it is not helpful you can stop at any time.

Nebraska Total Care offers Chronic Care Management services. This is to help our members with long lasting conditions improve their quality of life. Our Health Coaches help doctors, specialists, and the member work together for the best care. They teach the member about their condition. They help the member make a plan to improve their health.

Members with these conditions may benefit from Chronic Care Management:

  • ADHD
  • Anxiety
  • Asthma
  • Congestive Heart Failure
  • Diabetes
  • Depression
  • Hemophilia
  • Hepatitis C
  • Hypertension
  • Obesity/Weight Management
  • Pain Management
  • Perinatal Substance Use
  • Sickle Cell Disease

Our Health Coaches will listen to your concerns. They will help you get the things you need. They will talk to you about:

  • Understanding your condition
  • Making a plan of care
  • How to take your medicine
  • What screening tests to get
  • When to call your doctor or other provider

The goal of Chronic Care Management is to help you understand and take control of your health. Better control means better health.

For more information, call Member Services. The phone number is 1-844-385-2192 (TTY 711).

Community Health Services helps Nebraska Total Care members that need social services to facilitate successful medical treatment. Our Community Health program can help you get the care you need to be healthy.

They can talk to you about things like how to choose a doctor, plan benefits and living healthy. They can also connect you to community supports to meet your other needs. These could be programs to help you with food, housing and clothing.

They help members:

  • find doctors, specialists or other providers
  • find community support services
  • arrange for needed services
  • learn skills to improve their health

Community Health Workers can help you over the phone or come to your home. Call 1-844-385-2192 (TTY 711).

To empower those who impact the health and wellness of these children, we offer a Care Management program specifically designed for children in foster care. Our staff are dedicated to helping caregivers navigate the complicated health care and child welfare systems. Nebraska Total Care builds a care plan around each child enrolled in Care Management and partners with agencies throughout the state to coordinate services.

Care Management is available to every child in foster care enrolled with the Nebraska Total Care at no cost to the recipient. To enroll your foster child in Care Management, call 1-844-385-2192 (TTY 711). Choose the Care Managment option. 

This is for pregnant women who need extra support. Nebraska Total Care wants to make sure you get the care you need to have a healthy pregnancy and a healthy baby.

The Care Managers at Nebraska Total Care are registered nurses, therapists, and licensed social workers who will work with you to answer your questions. As your Care Manager, we can help schedule appointments, give transportation assistance and find support that will help you get well and stay well. We can also help with other behavioral and social services.

We can help find services in the community that will help you improve your health. We will work with you to:

  • Identify and address your basic needs
  • Help you get the services and support you need within your community
  • Teach you and your family how to handle your own care and resources

Our professional and diverse team has pre-birth, labor and delivery, postpartum, newborn nursery, and NICU experience. We are here to help you each step of your pregnancy.

To reach your Care Management team directly, call 1-844-385-2192 (TTY 711).

    View our member experience videos to see how Care Management has helped other members.