Ohio Department of Medicaid (ODM) in partnership with Maximus, the Provider Network Management (PNM) module vendor, is excited to share we are continuing our provider awareness and training efforts. Registration is now open for the April 19-26 PNM module refresher training. The training schedule is posted and available on the Next Generation website. Below you will find how to register and a list of training topics.
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Learning management system registration
Absorb, the learning management system (LMS), is where you can access virtual and self-paced training sessions. If you do not have an account in the LMS, it’s important that you create one to access all training sessions, answer forms, and view a variety of PNM module resources. Access the job aid and follow the steps to create your account and register for training.
Training module topics include:
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Account Administration and Dashboard.
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New Enrollment.
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Affiliations.
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Updates & Revalidations.
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Ohio Department of Medicaid (ODM) is committed to continuously improving the member experience. After hosting listening sessions in 2019 to collect input from members, ODM developed a new approach to care coordination as part of the Next Generation program.
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With the February 1 launch of Next Generation managed care plans, each plan now offers more care coordination services to help members navigate their care. More services also means additional specialized staff support, including four care coordination roles: care manager, care manager +, care guide, and care guide +.
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The care guide assists members with short-term goals and one-time needs.
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The care manager assists members with long-term goals and more complex needs.
ODM recognizes that individuals who receive services through ODM’s managed care program may have additional community supports through enrollment in a home- and community-based waiver, a comprehensive primary care practice, or the OhioRISE plan. These community supports are referred to as care coordination entities (CCE) or care management entities (CME) and provide care in addition to care coordination services provided through each managed care organization (MCO). Care coordination staff at MCOs support collaboration between the member, the plan, and the CCEs and CMEs.
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The care guide + works with CCEs and CMEs to support short-term needs and proactively avoid gaps in care.
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The care manager + works with CCEs and CMEs to support a member’s long-term, intensive needs.
The Next Generation managed care plan changes do not apply to MyCare Ohio plans, which continue to provide benefits to Ohioans who receive both Medicaid and Medicare benefits, with enhanced coordination of medical, behavioral, and long-term care services.
Providers can encourage members to reach out to their MCOs directly to learn more about care coordination. MCOs will help members identify the most appropriate support staff based on their health needs and goals.
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