Orchard - Unchanged

Case Management

Case management promotes client wellness and autonomy through assessment, planning, coordinating, monitoring, and evaluation of patient care. Case management enables patients and their families to make informed decisions and helps patients deal with the complexities of the healthcare system.

The goals of our case management department:

  • Identify high-risk or high-cost patients.
  • Assess treatment options and opportunities to coordinate care.
  • Improve quality and efficacy of care through individualized treatment plans.
  • Maximize the member's insurance benefits.
  • Manage patient needs in the appropriate setting to ensure the optimum outcome.

Several favorable outcomes include:

  • Reductions in in-patient admissions.
  • Reduced in-patient hospital days.
  • Fewer emergency room visits.
  • Improved utilization of in-home and hospice care services.

Physicians can refer patients for case management or members can self-refer. If you have a patient with complex medical needs, please call the PEHP prenotification line at 801-366-7755 or 800-753-7490 and the case will be forwarded to our case management nursing staff for review.

Download Nurse Case Manager Assignment Request PDF file