1. Assist the County in helping employees, pre-Medicare retirees, and insured family members improve health and manage serious and/or chronic health conditions. 2. Utilize data analytics based on the County’s claims data and clinical data of the members to: a. Identify and close gaps in care b. Identify potential prescription drug savings opportunities and work with member and care team to transition to lower cost medications c. Provide one on one case management to high-risk, high-cost members, and provide outreach to those most in need 3. Provide direct outreach to those members identified as high-risk, high-cost or as having gaps in care through mail, phone, and other direct communication methods. 4. Meet members where there they’re at in their health care journey including telephonic, telehealth, and in-person interventions. 5. Provide actionable information to the member’s providers regarding gaps in care and other recommended clinical interventions. 6. Collaborate with members’ medical providers as an integral part of the care team to assist members in managing various health conditions. 7. Work with County’s claims administrators to evaluate data and assist members. 8. Provide transparent reporting to the County identifying care management engagement, cost savings opportunities, and cost savings achieved through interventions. 9. Provide on- site employee support by attending at least one employer-sponsored employee health and/or wellness event yearly.
