Clinical Interventions   
Concurrent or Retrospective Clinical Review- HC21 will provide a nurse credentialed in case management to identify high risk/high cost members and collaborate with the health plan or vendor to review their care.  The review will focus on clinical interventions by Case Management (CM) / Disease Management (DsM).  Findings will be reported to the employer member with recommendations; such as increasing consumer incentives, strengthening health plan performance standards and other recommendations for process improvement.

Clinical Transition Oversight- When transitioning from one health plan to another, HC21 provides oversight to assure continuity and to minimize disruption of clinical services, like CM and DsM.

•    HC21 can identify employees with high cost claims and high health risks.
•    HC21’s nurse can assess if the new plan has contacted and enrolled employees in CM and DsM.
•    The nurse can also request the plan to give evidence of participation at certain intervals.
•   Participation is reported to our member to address issues, such as consumer incentives and health plan performance.

Health Nurse- HC21 can assist the employer with hiring (contracting) a nurse, job orientation, mentoring and managing.

Clinical positions would perform the following duties:
•    Assure complete, accurate health risk assessments
•    Collaborate with health plan / vendor to match population with the correct health plan service
•    Monitor clinical goal achievement
•    Provide health coaching as needed
•    Provide recommendations to the employer to improve the effectiveness of clinical intervention
•    Evaluate and maintain databases to identify targeted populations
•    Perform clinical reviews as described above

Please contact Gaye Fortner- HC21 President and Chief Executive Officer