Population Care Management

SoonerCare Population Care Management (PCM) coordinates and facilitate the delivery of health care to our members through the most appropriate resources, providers and facilities within the scope of the SoonerCare program.

The enhanced benefits of PCM offer both the patient and the provider more ways to help control complex conditions and improve quality of life. PCM is provided at no cost to our SoonerCare members nor our providers.

Population Care Management works with members identified through various programs or those who are in need of episodic or event-based health care (e.g. breast and cervical cancer patients or members with special needs). This includes a variety of obstetrical and pediatric services, as well as out-of-state care coordination, long-term care waivers reviews and complex case management.

  OB Case Management includes:

  • At-Risk Obstetrical Case Management
  • High-Risk Obstetrical Case Management

  Pediatric Case Management includes:

  • At-Risk Newborn Case Management
  • Infant Mortality Reduction Case Management (targets specific high-risk counties)
  • Private Duty Nursing Case Management

 Other Services:

  • Oklahoma Cares Program
  • Out-of-State Care Coordination
  • Complex Case Management
  • ER Utilization Case Management
  • Long-term Care Waiver Clinical Reviews
  • Social Service Coordination

 


 

 

Contact Us

Health care providers, family members and other care coordinators may request PCM services for beneficiaries 8 a.m. - 5 p.m. weekdays by calling 405-522-7650 (Oklahoma City area) or 877-252-6002 (toll-free). Services may also be requested by filling out our online Care Coordination Referral Form.