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© 2008 WellCare Health Plans Inc. All rights reserved. Onsite Nurse Care Manager Kathy Helm RN, BSN, CPHM Director, Utilization Management WellCare of.

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Presentation on theme: "© 2008 WellCare Health Plans Inc. All rights reserved. Onsite Nurse Care Manager Kathy Helm RN, BSN, CPHM Director, Utilization Management WellCare of."— Presentation transcript:

1 © 2008 WellCare Health Plans Inc. All rights reserved. Onsite Nurse Care Manager Kathy Helm RN, BSN, CPHM Director, Utilization Management WellCare of Florida

2 p 1 5/2/ :40 AM Onsite Utilization Management Program Onsite Inpatient Care Management nurses deployed at hospitals with census > 20 Allows for real-time collaboration with hospital staff Reduction in discharge delays Increased focus on Discharge Planning and Transitions of Care Reduction in admission denials Program expansion planned in 2015 for 12 additional hospitals ER Nurse Care Manager pilot program Integration with BH and Field-based Care Management Teams

3 p 2 5/2/ :40 AM Onsite Nurse Roster ONSITE HOSPITALNURSE PHONE Tallahassee MemorialGlenique Oak HillPatricia Memorial Hosp JacksonvilleMichole Shands JacksonvilleDenita St Vincent's Medical CenterVictoria CRMC Bayonet Point/TrinityNatalija Lakeland RegionalKathleen Wainoris Valerie Jaques St Joseph's HospitalAnna Tampa GeneralJohn Brandon RegionalNaomi Manatee MemorialAnnaMarie Lee Memorial/HealthparkOPEN Osceola RegionalMayra Borrero Arnold Palmer ChildrensJoselyn Wiscovitch-Caro ORHS Dr. PhillipsPearlie Williams Florida Hospital East OrlandoNancy Gonzalez pending Florida Hospital Orlando Diane Atherton Kimberly Howard Health CentralTamia Julius Orlando Regional Kathy Miller Angelina Torres-Narvaez Florida Hosp AltamonteEileen Wuesthoff Rockledge & MemorialOPEN Jackson MemorialCarolyn Enzinna

4 p 3 5/2/ :40 AM UM Administration Cynthia ScollinsVP, Health Services Dr Bruce Himelstein Medical Director, Fl Health Services Katherine Helm Director, Utilization Management Rubina ViraniSr. Mgr. Field Health Services


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