Integrated Care Management
Nebraska Total Care's integrated care management teams are available to assist members with medically or socially complex needs that may benefit from increased coordination of services to optimize health and prevent disease.
Our Care Management team is staffed by nurses, pharmacists, medical doctors, community health workers, psychiatrists, licensed mental health practitioners, alcohol and drug counselors, and social workers. We have staff who have been trained in understanding the foster care and criminal justice systems. We also have staff who specialize in NICU/PICU, cardiovascular issues, geriatrics, and pediatrics. The diversity of our team allows for us to collaborate and assess each members needs more effectively.
Care Management improves quality of care, medical adherence and self-management skills. Early intervention is essential to maximize treatment options while minimizing potential complications associated with catastrophic illnesses or injury and exacerbation of chronic conditions. A Case Manager is available from 8:00 a.m to 5 p.m. Central time to assist with coordination of the member’s healthcare needs.
The following conditions and/or diagnoses are examples of appropriate referrals to the Care Management team:
- Adults or children with serious or complex medical needs
- Social issues (social isolation, hunger, housing, domestic violence)
- High blood pressure
- Heart problems
- Substance use disorders
- Mental Health disorders
- Other disease management
- Start Smart for Your Baby® prenatal program
- Emergency Department (ED) diversion
- Readmission prevention program
The provider’s role in Nebraska Total Care's Care Management program is extremely important. Practitioners who have identified a member who they think would benefit from disease or care management should contact the Care Management team at 1-844-385-2192 (Relay 711) or submit a referral request using the secure provider portal.
Community Health Services
The Community Health team is trained to help our members get their health needs met. Community Health workers can travel to a member's home to help them. We help members:
- Find doctors, specialists, or other providers
- Complete health information forms
- Provide health coaching
- Find community supports
- Arrange needed services
Free 24/7 Nurse Advice Line
Members can call the Nebraska Total Care Nurse Advice Line any time. This service is free and they can answer health questions 24 hours a day, every day. Members can call 1-844-385-2192 (Relay 711). Our nurses speak English and Spanish. If a member speaks a different language, they can ask for a translator.