Our healthcare management model embraces the patient-doctor relationship, with proven and integrated clinical and health advocacy programs to cover the entire healthcare continuum. From traditional utilization management to one-on-one wellness and lifestyle coaching, to population health management, we adapt our services to the unique clinical needs of an employer’s entire membership.

Long-term consequences of unhealthy behaviors among members are significant. If a member postpones health services and interventions until absolutely necessary, an unattended condition can transform into a more serious concern, resulting in personal disability, lost workplace productivity and higher healthcare costs for the member and your health plan.

Utilization Management

CoreSource’s URAC-accredited Utilization Management provides pre-certification for inpatient services and an assessment by registered nurses of medical necessity for the appropriateness of services. Utilization Management from CoreSource has been proven to be more effective at achieving hard dollar savings than the national benchmarks for both HMOs and PPOs according to Milliman USA.

Case Management

Case Management from CoreSource is a collaborative process used to assess, implement and evaluate treatment options and medical services best suited for the healthcare needs of a member with a serious condition. Certified Nurse Case Managers maximize the member’s benefits and outcome with the most appropriate and cost-effective clinical resources available.

Population Health Management

Through preventive health, education, disease management outreach and ongoing clinical support of a health plan’s entire membership, YourCare, population health management from CoreSource, can reduce expense and gaps in care for high-risk members and those with chronic conditions, and improve compliance. See our white paper.

Wellness Programs

SHC will tailor a wellness strategy to reflect an employer’s benefit goals, budget and employee needs. A full range of wellness programs is offered to help employers learn more about their employee population and ways to motivate them to make healthier choices. We offer individualized health coaching, preventive screening reminders, biometric screenings, a health risk assessment, lunch-and-earn seminars, health fair planning and more.