Medical Management Programs

Programs to Help You Maximize Your Health Insurance Plan

As part of your health care benefit the Cox HealthPlans Medical Management Team is available to provide our members with the information needed to make informed decisions that maximize their plan benefits. Our members realize the benefit of our services through management of out-of-pocket expenses as well as assistance in navigating the healthcare system and health plan policies. Through various Utilization, Case, and Health Care Management techniques we will assist our members, family, and providers in managing complex cases to ensure the right services are being utilized at the right time and at the right level of care.

The Medical Management department is made up of a team of Registered Nurses, Certified Case Managers, Medical Resource Specialists, and a Board Certified Physician dedicated to assisting our members.

Medical Management programs are continuously being developed and deployed to meet the needs of our members in an ever-changing health care industry.

Our programs are developed to address:

  • Pharmacy utilization and costs
  • Importance of a Primary Care Physician (PCP)
  • Emergency care utilization
  • Preventive Care
  • Chronic Care Management
  • Quality Outcomes
  • Risk Management
  • Provider Access

We believe in taking a proactive management approach where Cox HealthPlans’ Medical Management Team identifies health care management needs in near real time and contacts members to ensure the best outcomes possible. Our team is also capable of receiving self-referral cases. We can be contacted by phone or in person Monday through Friday from 8 a.m. – 5 p.m.

Disease Management Programs

Our Disease Management Programs for diabetes, heart disease, asthma, and other chronic conditions are designed to help members take control of their health and improve their quality of life.

In an effort to help control costs, Cox HealthPlans has implemented various programs to assist members with their specific medical needs.

Contact one of our team members today at (417) 269-2900 or (800) 205-7665 to add one of our Medical Management programs to your group plan.