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CareConnect Case Studies
Horizon NJ Health

CareConnect Solution
IntelliSource Healthcare Solutions provided an integrated medical management solution for Horizon NJ Health, the largest Medicaid managed care organization in the state of New Jersey. IntelliSource designed, developed, implemented and currently maintain CareConnect, a state-of-the-art medical management system. CareConnect includes a flexible case management solution that integrates with a variety of systems in a real-time environment, allowing case managers to have timely access to key member and provider information.

RPR developed the following components for Horizon NJ Health: 

  • Easy to use graphical application to streamline all relevant member and provider information
  • Turn key integration into all required back end systems
  • Work queue environment for case managers to effectively managed their case load
  • Automated care planning system to allow case managers to automate the process of creating care plans
  • Health risk assessment module for automated assessments
  • EPSDT eligibility and claims tracking
  • Alerts and triggers based on user requirements
  • Integrated call and issues tracking
  • Update capability for recipient address
  • Authorization entry
  • Third-party liability (TPL) checking and coordination
  • Accumulators to determine eligibility for new Pennsylvania Medicaid benefit changes
  • Customized reporting system
  • HIPAA compliance
  • Security
  • System maintenance, modifications, and enhancements

The CareConnect system has significantly improved the productivity of case managers and support personnel by providing a streamlined system that offers a consolidated view of all member and provider information.  The system also provides users with a single system for completing health risk assessments (HRAs), care plans, and contact tracking.

It allows case managers to more effectively manage a larger case load by providing easy access to all data.
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