Manage Care

Review the Behavioral Health page that shows services available to Alliance members with mild to moderate mental health conditions, as well as resources for acute mental health needs.

Visit the California Children’s Services page to learn about this statewide program for members under 21 years of age with certain serious medical conditions. View information on benefits, services, eligibility requirements and how to become CCS-paneled.

The Alliance offers services and clinical resources to help providers deliver quality care to our members, including:

• Care management information.
• The 24/7 Nurse Advice Line.
• Referrals and authorizations information.
• Telehealth services.

The Alliance ensures that all members have access to and can understand health care providers and services. The Cultural and Linguistic Services page provides:

• Information on language assistance, including telephonic and face-to-face interpreter services.
• Resources for caring for diverse populations.

Enhanced Care Management (ECM) and Community Supports services coordinate both the clinical and non-clinical aspects of care for the highest-need Medi-Cal members and serve as cost-effective alternatives to covered Medi-Cal services.

Refer to the Health Education and Disease Management page for information on the Alliance’s health programs, disease management programs, incentives and wellness resources for members.

Visit the Pharmacy page for details on formularies, authorizations, billing and reimbursement, specialty and mail order pharmacies, pharmacy benefits and more.

Our Quality of Care provider resources include information on incentives, site review processes, and tools and assessments to aid in providing quality care to members. Learn more about:

• Provider Incentives.
• Health Assessments.
• The Healthcare Effectiveness Data and Information Set (HEDIS).
• Immunization Resources.
• Member Incentives.
• The Consumer Assessment of Healthcare Providers and Systems (CAHPS).
• Site Reviews.