Complex Case Management Program

MediGold aims to take care of members who have experienced a critical event or diagnosis that requires extensive use of resources. They may need help navigating the system to facilitate appropriate delivery of care and services. This program goes beyond providing case management for one complex condition, e.g., transplant member or members already enrolled in MediGold disease management programs.


The scope of services provided by complex case manager to the members include:

  • Initial assessment of health status.
  • Education about the case management program.
  • Development of a member-specific care plan with goals, task, barriers, opportunities and self-management skills.
  • Reassessment of progress against the member care plans and evaluation of adherence.
  • Based on acuity, regularly scheduled contact with the case manager.
  • Assistance in navigating and collaborating with practitioners and community resources regarding treatment.
  • Supporting transitional care between inpatient to other facilities or home.
  • Discussion with interdisciplinary team to review treatment plan and interventions.


Updated 01/2020