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A member guide to the complex case management program

Let our health care team help you!

Want to make your life easier and make your health care even better? That’s what we’re here for. UPMC Health Plan’s complex case management program can provide members like you with a care manager at no cost.

Whether you have a complex medical health need, a behavioral health need, or a chronic condition—like diabetes, asthma, COPD (chronic obstructive pulmonary disease), depression, or anxiety—our personal care managers will work with you to find a program to help.

Benefits of joining a complex case management program

Our complex case management programs match you with a care manager (a registered nurse or social worker) who will personalize services to fit your condition. The care manager can help you make the most of your health care, no matter your needs.

Personal care managers can:

  • Work with your doctors.
  • Help you get the health care services you need.
  • Help you understand your treatment plan.
  • Teach you or your caregivers how to manage conditions.
  • Connect you with community programs.
  • Support your treatment plan.
  • Develop a plan to help you manage your condition on your own.

The program may also connect you with a care manager who can:

  • Offer further support in managing your health condition.
  • Give you tips about healthy eating and exercise routines.
  • Encourage you to take your medicine as directed.
  • Remind you to schedule your doctor appointments.
  • Talk to you about your health, diet, and medications.
  • Talk to your providers to let them know how you are doing (with your permission).

How to enroll in a complex case management program

If you have questions about the complex case management program or the health management program—or just want to learn about other programs that might benefit you—call a personal care manager at 1-866-778-6073. TTY users should call 711.

Staff members are available Monday through Friday from 8 a.m. to 4 p.m. to those enrolled in the program. You don’t have to take part in these programs if you don’t want to, and you can stop participating at any time.