Tailored Care Management (NC)

What Is Tailored Care Management?

Tailored Care Management is a North Carolina Medicaid service option. Care managers coordinate all aspects of a person’s healthcare needs to enhance their well-being and quality of life.

Individuals who opt for Tailored Care Management will be assigned a dedicated care manager. This Care manager, with the backing of a specialized team, collaborates with their physicians, links them to essential resources, and establishes a support network to achieve improved health and better quality of life outcomes.

Who Qualifies for Tailored Care Management?

Tailored Care Management provides specialized support to current members who have significant mental health needs, severe substance use disorders, or intellectual/developmental disabilities (IDD).

What Are the Benefits of Tailored Care Management?

Tailored Care Management works to create a more seamless healthcare experience:

Your dedicated care manager will create a personalized plan to coordinate your physical health and pharmacy requirements, as well as address your behavioral health and/or IDD service needs.
Care managers can also assist with other aspects that may impact your health and well-being, such as identifying suitable resources for housing, employment, food security, and more.

Your care manager will offer individualized support and assist caregivers/family members in effectively managing your healthcare needs.
Additionally, your care manager will serve as a central point of contact for streamlining your personalized care.

Why RHA?

At RHA Health Services, the people we serve and support are at the very center of everything we do.

For over 30 years, RHA has provided services for the IDD community, and through expansion, offers behavioral health and Deaf and Hard of Hearing services – and now we are excited to provide Tailored Care Management to community members across North Carolina.

As a company, we focus on helping people live their best lives. We achieve this by helping people set and attain personal goals, fostering and sustaining meaningful community connections and relationships, promoting positive outcomes in health and wellness, and much more. The addition of Tailored Care Management allows us to deliver even more personalized care to the people we serve.

Read about RHA’s Executive Director of Care Management.

How Do I Know if I Am Eligible for Tailored Care Management?

Members with Medicaid who have significant mental health needs, severe substance use disorders, or intellectual/developmental disabilities (IDD) likely qualify for Tailored Care Management. If you would like to verify your eligibility, you can call RHA or email the Care Management team. You can also contact your local Managed Care Organization/Tailored Plan to inquire.

For more information about North Carolina’s Tailored Care Management initiatives, visit NCMedicaidPlans.gov or call 833.870.5500.

When you are assigned to a Care Management Agency, you should receive a letter in the mail from your Managed Care Organization/Tailored Plan organization that notes the agency you are assigned to for Care Management. The letter will provide information about your eligibility and the agency to which you have been assigned. You can change the agency you are assigned to by contacting the Managed Care Organization. Once assigned to a Care Management agency, you will be contacted by a member of the Care Management agency to provide information about the program and schedule your first visit.

How Do I Enroll in Tailored Care Management?

Members who qualify for Care Management are automatically enrolled and assigned to a Care Management Agency (CMA), which may be a provider-led agency like RHA, or they are assigned to the MCO/Tailored Plan.

Upon assignment to an agency, a care manager will contact the member via phone calls, letters, etc., to provide education on the program and obtain verbal consent to participate. The care manager will schedule an assessment of the member’s needs.

If you are assigned to another CMA and want to switch to RHA, contact your MCO/Tailored Plan to make this choice.

Unsure if you qualify? Contact your MCO/Tailored Plan member services line or RHA. We can help determine eligibility and find your assigned CMA.

Participation in Tailored Care Management is a right, not a requirement. A member’s care will not change if they choose not to participate. A member can choose to participate at a later time if they still meet the eligibility requirements.

If I Have Questions About RHA’s Tailored Care Management Program, Who Should I Contact?

Email our Tailored Care Management team at caremanagementnc@rhanet.org.

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Tailored Care Management

Improving Health Through a Coordinated System of Care