Case Management:
Effective Oversight for the Most Complex Cases

MedWatch’s certified nurse Case Managers review, monitor, and advise on the most acute and complex cases to improve quality of patient care and minimize treatment costs.


Case Management You Can Trust

MedWatch’s URAC Accredited CM Program supports patients by collaborating with their providers, proactively addressing needs, reviewing treatment plans, and providing options that enhance patient care while reducing costs. MedWatch’s accreditation in Case Management demonstrates our ongoing commitment to delivering quality services by providing the highest standards of care.

Better Programs. Superior Outcomes

MedWatch's nurse case managers proactively engage patients and work with their physicians to help ensure effectiveness of treatment plans and quality of patient care while reducing the overall costs.

Early identification and action is critical to reducing costs and improving patient outcomes. MedWatch identifies opportunities through:

  • Pre-certification Activity
  • Multiple Admissions
  • Trigger Diagnoses
  • Pathology, Radiology, and Other Diagnostic Outcomes
  • Referrals from the Plan, Administrator, or Patient

Average Payer Savings Ratio

6.5:1 Overall Case Management

Specialty Case Management

Transplants 11:1
Oncology 12:1
Mental Health/Substance Abuse 11:1
High Cost Medications 15:1
Pain Management 9:1
Pediatric/High-Risk OB 8:1

Cost-Saving Components for Every Case

MedWatch Case Management helps control the high costs of acute and complex cases which includes medical necessity reviews, looking at options for surgical bundles, pharmaceutical bundles, and Centers of Excellence.

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Centers of Excellence & Specialty Networks

Highly personalized, comprehensive, expert care provided through secured network, hospital and outpatient care centers for transplants, oncology, orthopedics, and more.

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Pharmaceutical Solutions

Focuses on high-cost, specialty, and maintenance medications with our programs dedicated to providing significant savings

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Surgical Bundles

All-inclusive packages that cover the most commonly performed surgical procedures at a cost well below traditional PPO rates

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Medical Necessity Reviews

Nurse Case Managers review targeted treatment plans relative to approved clinical standards and benefit plan design

Explore MedWatch Services

Click below to explore our other services.

Pathways Concierge

Utilization Management

Case Management

Disease Management

Claims Solutions

Ancillary Services

Direct Contracts

Want to See More?

Request your own copy of our Services Overview!

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