Identifying Need for Care Management. Contractor’s goals, benchmarks and strategies for managing the care of Enrollees in its traditional Disease Management Programs shall be incorporated in, and included as part of, Contractor’s Care Management program. Contractor shall use population and individual-based tools and real-time Enrollee data to identify an Enrollee’s risk level. These tools and data shall include, but not be limited to, the following:
Identifying Need for Care Management. The Contractor shall use population- and individual-based tools and real-time Enrollee data to identify an Enrollee’s risk level. These tools and data shall include, but not be limited to, the following:
