Care Management

We are here for you!

Care Management is a service that provides personalized care to patients with chronic health conditions. Our RN Patient Care Coordinator is here to help, support and encourage you to a healthier life. The Care Coordinator will work closely with the patient and their support network (caregivers, spouse, family) to promote self-management skills, keep communication open with the patients provider team, connect the patient to community resources and help maneuver the healthcare system.

What you can expect when working with your RN Care Coordinator

• Patient centered care plan with clear details and goals
• Guidance with timeframes for follow-up tests and appointments
• Guidance with specialist visits
• Assistance with medication management
• Clear and consistent communication amongst your care provider team
• Improved access to community resources

What can you expect the first time you meet with your RN Care Coordinator

Your Care Coordinator will meet you in person or via telephone initially to create a care plan custom to you. At this time the Care Coordinator will complete a comprehensive medication reconciliation and assess your needs. The two of you will create small goals to strive for in the next 30 days. This is also the time when you can communicate what hurdles you are having tending to your healthcare needs. The Care Coordinator can work with you on solutions to those hurdles.

After the initial call you can expect to hear from your Care Coordinator on a monthly basis either by telephone or by in office visit. At those intervals your care plan will be reevaluated and adjusted appropriately. You will always have access to your Care coordinator through the MyChart portal, email or by telephone. Your Care Coordinator will always be working closely with your provider team to make sure your care plan is in alignment with your provider's treatment plan.

The Benefit is Yours!

The RN Patient Care Coordinator is a benefit to you and your health. Care Coordinators are here to help move you in the right direction for your chronic conditions. They strive to keep you out of the Emergency Room and hospital.

If you feel like Care Management with one of our RN Care Coordinators is the next best step for you please let your primary care provider know.