Valor Health Plan

• Triages care needs based on the Health Risk Assessment Tool (HRAT) scores. Conducts clinical assessments on an ongoing basis.
• Provides input into the development of the ICP in collaboration with the case manager and other members of the ICT.
• When needed, interfaces with other practitioners to help facilitate access to all services (IP, SNF, specialist care, behavioral health, etc.).
• Visits the patient as scheduled and after hospital discharge to evaluate progress, conduct physical exams, prescribe interventions, and communicate results to staff.
• Evaluates episodic complaints and initiates treatment in place when appropriate.
• Obtains consultation and diagnostic reports and reviews as needed with the Medical Director and ICT.
• Identifies and addresses changes in the members’ health status by being available on call when not at the NF during scheduled visits. There is a CNP on call 24 hours a day, 365 days a year to address member needs.
• Supervised clinically by the Medical Director and operationally by the Care Coordination Director.
• Advocates, informs, and educates beneficiaries and family members on self-management of conditions through regular meetings and informal discussions.
• Educates Nursing Home staff through ICT meetings and regular communications when on site.

Valor Health Plan HMO Special Needs Plan with Prescription Drug for Institutional Residents (2024)