What we do

Medical Management

Our compassionate and experienced case managers, nurses and medical directors become your personal advocate when faced with healthcare decisions. We're here to help navigate the healthcare system and support your wellness journey.​

Our comprehensive suite of medical management services are provided by our own staff in our Bloomington office (no services are subcontracted). These services aid in the health of your employees and produce significant health plan cost savings. Members can access these services, including our 24-hour nurse line, by calling their dedicated phone number.

Programs

  • Utilization Management – We provide close monitoring of inpatient hospital admissions, certain outpatient procedures and review requests for medical necessity.
  • Case Management – Nurse case managers assist with complex medical and behavioral situations, like cancer or substance abuse, via support and education during diagnosis and treatment. 
  • Maternity Management – High-risk assessments are completed for each pregnancy aiming to aid in a healthy full-term baby for the parents. This also results in health plan cost savings.
  • Disease Management – Members with conditions such as asthma, diabetes, or heart disease will have the opportunity to participate in our disease management program. Our goal is to help members restore their health as best we can and minimize any disease progression. 
  • Wellness Management – We work with you to design a successful wellness program that motivates and engages your members. Your wellness programs are based on your member’s specific needs and population data and motivation triggers. These include, but not limited to, smoking cessation, weight management, getting active and more. Our EZfit program makes it easy for members to get credit for their health club workouts. Alternatively, based on your needs, we can also partner with local providers for wellness programs. 

Let’s continue the conversation

Connect with our team today.