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

In September’s Provider Enews, we provided an overview of the CCO enrollment process. To help streamline the new member experience, ACANY recently implemented the specialized position of New Enrollment Care Manager.

When a person is enrolled in Care Management, they are assigned to a New Enrollment Care Manager for their first 90 days. The New Enrollment Care Manager ensures that all activities needed for people newly enrolled in a CCO are completed thoroughly and timely. This helps link people to needed supports and services as quickly as possible.

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

  • Contact new enrollees 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 with the initial comprehensive assessment

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

  • Complete the comprehensive assessment process
  • Review service needs
  • Schedule and participate in the initial Life Plan meeting
  • Assist in applying for the Home and Community Based Services (HCBS) Waiver and/or discuss Family Support Services
  • Review and update consents and authorizations as needed for service 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.