What we do

Medical Management

Our compassionate and experienced case managers, nurses and medical directors become our members’ personal advocates when they face healthcare decisions. We're here to help members navigate the healthcare system and support their wellness journey.​

Helping Members Manage Their Health

Our comprehensive suite of medical management services are provided by our own staff in our Bloomington, Minnesota 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 HelpEZ, our 24-hour help line, by calling their dedicated phone number.

Medical Management Programs

Our medical management programs help members better manage their health and reduce health plan costs for employers. These programs include:

  • 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,  to aid in a healthy, full-term pregnancy.
  • 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 as possible and minimize disease progression. 
  • Wellness Management: We work with you to design a successful wellness program that motivates and engages your employees. We design these programs based on your employees’ specific needs, population data and motivation triggers. These programs include smoking cessation, weight management, EZfit, which is a fitness program that gives members credit for working out,  and more. We can also partner with local providers for wellness programs.

Let’s continue the conversation

Connect with our team today.