Care Smart Case Management offers the following services:
Providing traditional and enhanced case management services in the following Georgia counties: Cherokee, Clayton, Cobb, Dekalb, Douglass, Fayette, Fulton, Gwinnett, Henry, and Rockdale
Qualifying current and potential Medicaid members to access Medicaid-funded waiver services under the CCSP EDWP Program.
Engaging in planning, arranging, coordinating, and evaluating Medicaid-funded service delivery
(Both Traditional/ Enhanced EDWP)
Brokering Medicaid Members waiver services with provider agencies and other service providers
Identifying and arranging non-Medicaid resources/services for EDWP Program members
Coordinating with Medicaid provider agencies to assure comprehensive service delivery of members
Assisting Medicaid members with obtaining ancillary services such as medical transportation, Home Delivered Meals and durable medical equipment
Creating comprehensive Care Plan (CCP) reviews for EDWP Program Members
Monitoring member health changes and the care provided to assure that services are rendered by the service providers as ordered in the Care Plan
Identifying, resolving and monitoring issues related to members quality of care and timely delivery of services
Ensuring that Medicaid members are free from abuse, neglect of care and exploitation by provider agencies
Initiating actions to address events which may adversely affect Medicaid members’ health status
Initiating discharge planning in the event of death, relocation and occurrence of other life changing events
Working closely with Medicaid members to be familiar with their needs and preferences and taking actions to meet these needs.
Acting as advocate for Medicaid members in the human service bureaucracy and brokering services
Assisting EDWP Program members with appeals relating to requested changes in service delivery.
