Community Care of the Sandhills
Community Care of the Sandhills (CCS) is managed by a Medical Director and Network Director who work in tandem to accomplish the goals of the network. These leaders report directly to the CCS Board of Directors. Financial activities are completed by a Finance Officer, information technology needs are implemented by an IT Coordinator and Quality and Compliance Coordinator. A PharmD is also on staff to assist in pharmacy initiatives and to provide medication assessment for both CCS staff and providers.
CCS is responsible for delivering targeted care management services to improve quality of care. Care managers play a central role in helping CCS achieve this goal. CCS currently employs 43 nurse care managers who focus on accomplishing this task. Please refer to our Staff Menu for care manager name and county.
Each participating practice is assigned a care manager. Working with the Medical Director, the care managers also provide participating practices with the tools and resources they need to adhere to current national guidelines for CCS disease initiatives. The care managers are primarily responsible for helping to identify patients with high risk conditions or needs, assisting providers in disease management education and/or follow up, helping patients coordinate their care or access needed services, and collecting data on process outcome measures. The services provided and regularity of contact by the care manager depends on the intensity of the patients' need. The majority of enrollees can be taught to manage their own disease and generally require initial patient education and/or intermittent follow up. Care managers also provide ongoing patient support to help them keep appointments, take medications, and follow diet and other doctor's instructions. The personal attention each patient receives helps avoid unnecessary hospitalizations and repeat visits to the doctor resulting in cost savings for the state.
While CCS develops its own care management focus based on its knowledge of the local resources and "stake holders" in the care of the patient, the care coordination process is consistent between all 14 networks of CCNC. To assure consistency across networks, a "setting expectations" workgroup composed of leadership and program staff collaborates in the development of a "Standardized Case Management Plan" that has been implemented in each network. The plan consists of a set of guidelines and standards for care management activities and reporting across the CCNC networks.