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Transitional Care Case Management

  • We are a short term outpatient case management program that promotes continuity of care for our members who have been discharged from the hospital
  • We provide outreach to members identified as medium-to-high risk for frequent hospitalization and/or emergency services
  • Our team addresses any medical and non-medical barriers that could cause a readmission
  • We provide coordination with any appropriate KP or community resources that could benefit our members
  • We provide telephonic case management services for approximately 30 days after discharge
  • Our staff includes RN Case Managers, Medical Social Workers, and Operations Specialists