Case Management


Offered to you as part of your healthcare plan, Prairie States Case Management is a clinical service that advocates on your behalf if you’re facing a severe or complex medical issue, such as:

  • Cancer care
  • Dialysis
  • Multiple chronic conditions
  • Traumas
  • High-risk pregnancies
  • Transplants and more

The Best Care at the Best Price
Case Management focuses on multiple components of patient care including quality, safety, setting and cost. Our certified Registered Nurses will be with you every step of the way to ensure you get the best care, at the right time, and for the best price.
Following major surgeries, inpatient stays, maternity and condition management needs, Registered Nurses also manage Transitions of Care. They offer clear, detailed discharge education, and monitor follow-through with physician appointments, dressing changes, and medication adherence.
Guidance and Education
If you are identified as a candidate for Case Management, you will be contacted and encouraged to participate in this voluntary program. When you elect to take part, Prairie States helps manage your procedures, conditions and treatment plans with your providers. Throughout, Case Management Registered Nurses offer guidance before, during and after each specific episode of care.
Complete Integration
Collaboration and integration are key. The Case Management team works closely – and in real time – with you, claims examiners, providers and employers. Diverse members of the Health Management team combine their expertise, working together to ensure that necessary and cost-effective treatments are used to best serve you.
Quality Care, Personalized Attention, Unmatched Savings
The exceptional patient care and plan savings realized through Prairie States’ Case Management program are no fluke. With nurses comprising over 30 percent of our staff, the depth of our clinical expertise and experience are unique in the industry. From diagnosis to recovery, the entire Case Management team works tirelessly during every step of the treatment process to ensure that all members engaged in the program get the quality care and attention they deserve—all at the best value for the plan.