Care Management

Care management is a free benefit available to qualifying Vaya Health members who may need special medical and social support. Care managers work with members to identify their strengths, understand their needs, and build a personalized plan of care that is right for them.

How Care Management Helps You

Care management gives you more control over your personal health and wellness. Your care manager works closely with you to make sure your voice is heard. Together, you will create a plan that includes the services and supports you need to stay healthy, safe, and satisfied with your care.

Your care manager also pays attention to your life “outside the doctor’s office.” This may include linking you to appropriate medical specialists or supporting your healthy eating and sleep habits. Our person-centered planning process ensures that we work closely with you to make sure your choices are respected.

Your care manager can connect you to community resources to help with needs such as housing, work, transportation, or food. To learn more, talk to your care manager, submit a Community Resources Referral Request, or visit our Local Resources webpage.

For more information, call our Member and Recipient Services Line at 1-800-962-9003.

Tailored Care Management

Tailored Care Management Providers

Click here to view the list of providers that deliver Tailored Care Management to Vaya members. The list includes Advanced Medical Homes Plus and Care Management Agencies.

Tailored Care Management Opt-Out and Changes

To choose or change your Tailored Care Management provider or care manager, call our Member and Recipient Services Line at 1-800-962-9003 or download this form.

Members can also choose not to have a care manager and not receive the Tailored Care Management benefit. We will help you coordinate services, but the coordination will be more limited than Tailored Care Management. To opt out of Tailored Care Management, call our Member and Recipient Services Line at 1-800-962-9003 or download this form.

Care Management Referrals and Resources

Care Management Referrals

We accept internal and external referrals for care management from any organization or individual (including members, caregivers, hospital discharge planners, the NC Division of Juvenile Justice and Delinquency Prevention, local Department of Social Services agencies, primary care and behavioral health care providers, disease management programs, utilization management programs, health information lines, etc.) using the Vaya Health Care Management and Care Coordination Referral Form.

Child and Youth Services Resource Guide

Use Vaya’s Child and Youth Services Resource Guide to learn about:

  • Resources for child-serving agencies about Medicaid services available through Vaya
  • How to access routine and emergency care
  • DSS escalation strategies