Case Management

High-quality, cost-effective care for serious illness or injury

Returning to good health after illness or injury requires high-quality, attentive patient care. At the same time, it can be difficult to navigate your healthcare during times of serious illness or injury. That’s where Vālenz Care Case Management comes in, providing comprehensive guidance to ensure plan members receive medically necessary, in-network care that targets optimal outcomes while reducing costs.

Our Case Management program matches each qualified member with a dedicated Nurse Case Manager (a highly experienced registered nurse), who coordinates care and provides comprehensive guidance throughout treatment. Using proactive engagement and collaboration, our case management services can help manage costs and quality of care by reducing ER visits, hospitalizations and other high-dollar claim events. Members can focus on maximizing their quality of life, while employers focus on ensuring cost-effective care.

Benefits of Case Management

Lower costs for employers and members

Our Nurse Case Managers work closely with patients, providers and payers to ensure cost-effective, medically necessary care at all times.

Streamlined path to good health

We help patients stay on track for optimal outcomes by coordinating care and guiding patients through treatment across multiple care settings.

Patient-focused attention and support

Case Management facilitates comprehensive care with one central point of contact, who monitors rehabilitation and recovery every step of the way.

Prescription drug evaluations

Going beyond the care setting, our Nurse Case Managers also evaluate prescription drug regimens for safety, effectiveness and lowest-cost options.

URAC Accreditation

With our URAC-accredited Case Management solution, you have a smarter way to manage health administrative costs while improving quality of care. Learn more about our URAC-accredited Disease Management and Utilization Management services services, two additional solutions from Valenz Care that lower costs and improve care.

The Smart Way to Invest in Member Health

Valenz Care solutions – Case Management, Disease Management and Utilization Management – yield an average ROI of 10:1.

Experience the Synergy

When we say the Valenz ecosystem is comprehensive, we mean it. With a complete selection of fully integrated wraparound solutions to complement the core solutions featured below, we deliver benefits far greater than the sum of all these parts individually.

Vālenz Access

Combine a quality-first provider network or open solution with a range of customized, data-driven services from the Access Solutions Suite.

Vālenz Care

Guide members to better care and outcomes at lower costs, for you and for them, with RN-led, triple URAC-accredited care management.

Vālenz Claim

Reduce costs and ensure accurate payments with comprehensive bill reviews and repricing methodologies, integrated analytics, and more.

Vālenz Assurance

Improve coding, reimbursement assurance, auditing, claim accuracy and compliance monitoring, all while saving time and costs.

v-Lens

Use advanced, drill-down analytics and predictive modeling to continuously disrupt the cost curve without compromising quality.

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