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Care Management and Care Coordination Assistance

YCCO can help organize your care. YCCO has staff that are part of your care coordination team. YCCO staff are committed to supporting members with their care needs and can assist you with finding physical, dental, behavioral, developmental, and social health care where and when you need it. Your YCCO Care Management and Care Coordination staff is comprised of Nurses, Social Workers and Community Outreach Specialists, who are Community Health Workers.

You may get Care Coordination from your patient-centered primary care home (PCPCH), primary care provider, YCCO, or other primary care teams. You, your providers or someone speaking on your behalf can ask about Care Coordination for any reason, especially if you have a new care need or your needs are not being met. You can call YCCO at 833-257-2191 for more information about Care Coordination.

Care Coordination’s goal is to make your overall health better.

YCCO must have processes in place that help us find your health care needs. We will help you take charge of your health and wellness. Your care coordination team will:

  • Help you understand your benefits and how they work.
  • Work with you in your preferred language.
  • Use care programs to help you manage chronic health conditions such as diabetes, heart disease and asthma.
  • Help with behavioral health issues including depression and substance use disorder.
  • Help with finding ways to get the right services and resources to make sure you feel comfortable, safe, and cared for.
  • Help you identify people in your life or community that can be a support.
  • Help you pick a primary care provider (PCP).
  • Provide Care Management and advice that is easy to follow.
  • Help with setting up medical appointments and tests.
  • Help you set up transportation to your doctor’s appointments.
  • Help transition your care when needed.
  • Help you get care from specialty providers.
  • Help make sure your providers talk to each other about your health care needs.
  • Create a care plan with you that meets your health needs.

Your care coordination team can help you find and access other resources in your community, like help for non-medical needs. Some examples are:

  • Help in finding community resources to address rent and utility needs.
  • Accessing Nutrition Services.
  • Identifying trainings and classes to help address health care needs.
  • Identifying social services to help address health and social needs.
  • Accessing Health Related Social Needs.

Working Together for Your Care

Your care coordination team will work closely with you. This team will have different people who will work together to meet your needs, such as providers, specialists, and community programs you work with. The team will connect you with community and social support resources that may help you. Your care team’s job is to make sure the right people are part of your care to help you reach your goals. We will all work together to support you.

You May Need a Care Plan

You and your care team will decide if a care plan is needed. This plan will help meet your needs and is made with you, your care team and providers. Your plan will list supports and services needed to help you reach your goals. This plan addresses medical, dental, cultural, developmental, behavioral and social needs so you have positive health and wellness results.

The plan will be reviewed and updated at least annually, and as your needs change or if you ask for a review and update.  You, your representative and your providers will get a copy of your care plan.

You, an authorized representative or provider can request a copy of your care plan or request development of care plan by calling your care coordinator, the Care Management Department at 833-257-2191 or by emailing caremanagement@yamhillcco.org.

Members with Medicare

You can also get help with your OHP and Medicare benefits. A staff member from YCCO care coordination team works with you, your providers, your Medicare Advantage plan and/or your caregivers. We partner with these people to get you social and support services, like culturally specific community-based services.

Care Coordination Hours & Contact Information

Care Coordination services are available Monday through Friday 8:00 a.m. to 5:00 p.m.

  • Call YCCO at 833-257-2191 if there is a change in your health, needs or who you are working with so YCCO can help coordinate your care.
  • Call YCCO Care Management at 833-257-2191 to get more information about Care Coordination
  • YCCO Care Management will call or mail you or members representative a letter to let you know who, from your care coordination team, is primarily responsible for coordinating your care and services as well as how a member will be notified should that designated entity change. If there is a change to this person, we will mail you a letter or call you to tell you.