UPMC Health Plan: Health & Wellness
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SNP complex case management program

Many of our UPMC for Life Specialty Plan members have complex medical or behavioral health conditions. These members may benefit from additional support. UPMC Health Plan has a complex case management program that can help. This program is designed to collaborate with the providers who are caring for the member. Services include coordinating health care services, supporting the treatment plan, identifying gaps in care, providing management education to the member and caregiver, and linking the member and caregiver to community support.

Care management staff will attempt to contact members identified as having complex conditions to explain the program. If the member agrees to participate, staff will assess his or her needs to develop a plan with the provider, member, and his or her caregiver. The care manager will contact the provider when needed to clarify the plan. If you have a UPMC for Life Specialty Plan member whom you feel could benefit from the complex case management program, you may refer him or her by contacting us at 1-800-606-8648 and selecting option 4 for case management. Staff members are available Monday through Friday from 8:30 a.m. to 5 p.m.