Care Management

Care management is a free benefit available to qualifying Vaya members who may need special medical and social support. Care managers work with members to identify their strengths, identify 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 and your needs are understood. 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 helping you find resources in your community, 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.

To learn more, call Member and Recipient Services at 1-800-962-9003 (Mon.-Sat., 7a.m-6p.m).

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, departments of Social Services, primary care and behavioral healthcare providers, disease management programs, utilization management programs, health information lines, etc.) using the Vaya Health Tailored Care Management 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

Tailored Care Management

Tailored Care Management Providers

Click here to view the list of providers who contract with Vaya either as an Advanced Medical Home Plus (AMH+) or Care Management Agency (CMA) to deliver Tailored Care Management to Vaya members.

Tailored Care Management Opt-out and Changes

Eligible members and beneficiaries can choose or change Tailored Care Management provider anytime. To choose or change a Tailored Care Management provider, call the Vaya Member and Recipient Services line at 1-800-962-9003 or download this form (Español).

Members and beneficiaries 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 the Vaya Member and Recipient Services line at 1-800-962-9003 or download this form (Español).