A young woman in a wheelchair looks at a tablet with a young man who is sitting on a park bench.

NEW ENROLLMENT CARE MANAGER

What to Expect in the First 90 Days

To help streamline the new member experience, ACANY has recently implemented a targeted allocation of Care Management tasks within an identified group of Care Managers to focus on the specialty of new enrollment activities that occur in the first 90 days of enrollment. Referenced further as the “New Enrollment Care Manager,” these Care Managers work with new members during their first 90 days, ensuring that all activities needed for people newly enrolled in the CCO are completed thoroughly, timely, and guided by person-centered engagement principles.

In the first 30 days, the New Enrollment Care Manager will:

  • Contact new members within 5 business days to review their role as a specialized short-term Care Manager and what to expect from Care Management services
  • Schedule and complete an in-person face-to-face meeting
  • Provide an overview of the of service delivery system, both OPWDD funded and community resources
  • Begin the person-centered planning process by engaging with the member to begin the initial comprehensive assessment

Within 30-60 days, the New Enrollment Care Manager will:

  • Work with member to complete the comprehensive assessment process and identify any service needs
  • Schedule and facilitate the initial Life Plan meeting in partnership with the member
  • Assist in applying for the Home and Community Based Services (HCBS) Waiver, Family Support Services, and/or other community-based services
  • Review and update consents and authorizations as needed for referrals

Within 60-90 days, the New Enrollment Care Manager will:

  • Finalize the Life Plan with the person supported
  • Finalize and submit all documents required for HCBS Waiver application (when needed)
  • Schedule and complete a transition meeting with the person’s ongoing Care Manager

After 90 days, the ongoing Care Manager will:

  • Continue relationship development with ongoing communication, including in-person meetings, phone, email, secure texting, and telehealth (if chosen by the member)
  • Follow up on the status of the HCBS Waiver application (when needed)
  • Coordinate OPWDD services, medical and behavioral healthcare, educational services, and community supports

If you have any questions about the CCO enrollment process, please contact your regional Director of Provider Relations.