Case Management Services

When a member is diagnosed with complex health problems, a SummaCare Case Manager monitors the clinical care the member receives. 

Case Managers are registered nurses who assist members by helping with transitions between hospital and home or other care settings and helping members access needed health and support services.

Short-Term Case Management

Case management services may be short-term for members who are transitioning home after a hospital stay or when a member is new to our plan and needs help finding new doctors within the network.

Complex Case Management

Case management services may be long-term for members with catastrophic or highly complex problems. For members with complex needs, SummaCare Case Managers will assist in understanding the condition and will coordinate arrangements for complicated plans of care. The SummaCare Case Manager stays in touch with doctors and other caregivers and provides assistance with finding needed care within the plan network.

Transitional Case Management

In the event a SummaCare member reaches the plan limits on certain types of care, a SummaCare Case Manager is available to help the member find other resources.

Pediatric-to-Adult Care Case Management

A Case Manager is available to help SummaCare members arrange for adult care during a transition from child/adolescent needs to adulthood. Our provider search is also available to help find a new provider for someone entering adulthood.

To contact a Case Manager for help with a transition, call 330-996-8931 or 877-888-1164 (TTY 800-750-0750) Monday-Friday between 8:30 a.m. and 5:00 p.m. EST.

For more information about SummaCare’s Case Management Program, call 330-996-8931 or 877-888-1164.