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UWMF,

Business,Organizational Services,

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Departments & Programs,UW Medical Foundation

Medical Management

Medical Management - Departments & Programs, UW Medical Foundation

Focus

Medical Management's Mission

UWMF Medical Management Department's mission is to work collaboratively with members, the health plan, practitioners and health care vendors to maximize the effective and efficient use of health care resources and to facilitate coordination of health care services for those members with complex medical needs.

BadgerCare Plus Mission

Unity Health Insurance BadgerCare Plus staff are dedicated to advocating, coordinating and providing an enhanced level of support to BadgerCare Plus members and BadgerCare Plus providers in order to fulfill contractual guidelines. The BadgerCare Plus staff provide personalized member centered outreach to promote health education and prevent and manage chronic disease.

FAQ

How does Medical Management relate to Unity Health Insurance?

Unity Health Insurance is a wholly-owned subsidiary of University Health Care, Inc. (UHC). The University of Wisconsin Hospitals and Clinics Authority (UWHC) and the University of Wisconsin Medical Foundation (UWMF) are members of UHC. Unity contracts with the Health Services and Medical Management staff of UWMF to provide clinical expertise on behalf of the HMO's members.

The Medical Management department focuses on two services for individual members: Utilization Management and Complex Case Management. Utilization Management assures that Unity members receive evidence-based care in an efficient, cost effective manner. It is coordinated care by communication between the member, provider and vendor.

Complex Case Management coordinates services for members with complex needs so they receive effective and efficient care. Complex Case Managers work collaboratively with the member, family, health care providers and community agencies to develop a comprehensive plan to meet an individual's physical, behavioral, and social needs.

Unity Health Insurance is part of a contractual agreement with the Wisconsin Department of Health Services to provide health care services to members of the BadgerCare Plus program. As part of the agreement, the BadgerCare Plus team is required to outreach to members to provide health education and chronic disease management in order to ensure good health outcomes.

Resources

Medical Management Staff Bios

Websites

Case Management Society of America (CMSA)

NCQA

Unity Health Insurance

Wisconsin Department of Human Services (DHS)

Wisconsin Primary Health Care Association