Care Management

Properly managing your health condition can seem like a full-time job. Our team can help you take care of yourself, get healthier, and feel better. Among the conditions we address, the following are highlighted:

• Diabetes. Our experts will talk with you about the importance of diet and exercise and how they can lower your risk of heart, kidney, and nerve damage. Your care manager can also teach you how to better monitor your vital signs. This can help you keep your blood pressure or other issues in check.
• A cardiovascular health condition. You can work with an expert to learn ways to monitor and control your blood pressure as well as to lower your cholesterol (a waxy, fat-like substance found in your cells) and triglyceride levels (triglycerides are a type of fat found in your blood). You’ll also learn about eating a heart-healthy diet, managing your stress, and getting regular exercise to avoid heart disease.
• A respiratory health condition. An expert can help you set up a symptom response plan, connect you to pulmonary rehab and teach you about your medicines. They can also talk with you about avoiding environmental irritants, using oxygen, and quitting smoking.
• A behavioral health condition. You can choose a program to help you manage your anxiety, depression, stress, grief, or substance use. You can also learn about programs or resources in your community.
• Chronic pain. An expert can talk with you about physical therapy, continuous movement, and other treatments. These treatments may be better long-term solutions than injections or surgery.

Pregnancy and childbirth. You can get support and useful information from registered nurses whose focus is obstetrics. They can help you:

• Before, during, and after pregnancy.
• Connect with licensed social workers.
• With newborn nursing and breastfeeding education.
• With family planning options.

Pediatric care management. Registered nurses and social workers can help you and your child with important things like:

• Finding specialists, scheduling visits, and preparing questions for doctor appointments.
• Understanding your child’s condition and how to manage it.
• Answering questions about different conditions, medicines, and resources. They can also help refer you to behavioral health services if needed.
• Providing specialized support such as those in the Neonatal Intensive Care Unit (NICU) or those needing shift care services.
• Easing transition from a hospital or facility discharge to home.
• Finding out if social factors are responsible for existing health issues.
• Coordinating local resources, in-home nursing, or a home health aide for your child.

Experience you can trust

Our care managers are experienced nurses and social workers who understand how to help people with health issues. They’ll take the time to understand your issues and needs, and they’ll listen to what you want to work on.

They can teach you about new or existing diagnoses (both physical and behavioral). They can review your medications and make pharmacy referrals, if necessary. They can connect you with a health coach to help you with lifestyle changes. They can also connect you with other community resources.

Making things easier for you

If you’re managing multiple conditions, chances are you’re seeing multiple providers. Our team can bridge the communication gaps between the providers and coordinate their services. This can help ensure you receive the best possible care. Team members can help you schedule preventive care services, as well as appointments with your primary care provider (PCP) or other providers.

Our team can help you move from one caregiver to another, and if you’re hospitalized, they can aid in your transition back home when you’re discharged.

Connect today

We make meeting with your coach or care manager as easy and convenient as possible. There are a number of ways to get started, including:

• Virtual visit through UPMC AnywhereCare:
  • Log in to or register for an account.
  • Once you are logged in, select Health Navigation.
• By phone: Call 1-866-778-6073. TTY users should call 711. Help is available Monday through Friday from 8 a.m. to 6 p.m.
• By asking your health care provider to connect you with Prescription for Wellness!
  • Your provider can write you a "prescription" to get extra support from a UPMC Health Plan care manager. These services are an extension of your provider's care and can help support your care plan. Your care manager will outreach to connect with you and "fill" your provider's prescription. Additionally, your care manager will send a feedback note to your provider detailing your progress.

Remember: You will not be charged a copay for working with a care manager!
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