Ridgeview Care Navigators

Ridgeview’s Achieve Care Management team provides you with extra support between visits so you can stay on track with your health. You will work with a Care Navigator who partners closely with your primary care provider to help manage your health, coordinate care and guide you through the health care system. This program focuses on the whole person, not just one condition.

How Achieve Care Management supports you

• Manage ongoing or complex health conditions

• Coordinate care between your primary care provider and specialists

• Answer medication questions and assist with refills

• Provide support following hospital or emergency department visits to help you recover and avoid a return visit

• Provide preventive care and wellness planning

• Connect you to community resources and support services

What to expect

• A personalized care plan based on your goals

• Ongoing support from your Care Navigator and care team

• 24/7 access to care team support for urgent needs

• Easy access through MyChart messages or by phone

• Help coordinating appointments, tests and follow-up care

• Proactive outreach when extra support may help

• Partnership with your family or caregivers (with your permission)

Who is eligible

• Patients living with complex, chronic conditions

• Patients who have experienced a recent hospital or emergency department visit

• Patients who need extra coordination or support

Questions?

Talk with your primary care team or contact your clinic to learn more. 

While some insurance plans cover these services, a monthly fee may apply depending on your coverage. Participants in this program can choose to discontinue services at any time.

Certified Health Care Home

Ridgeview Clinics are a Minnesota Department of Health Certified Health Care Home. A Health Care Home is a primary care clinic or clinician certified by the Minnesota Department of Health to coordinate care among the primary care team, specialists and community partners as a collaborative care team by ensuring patient-centered, whole person care and improving total health and well-being. The Health Care Home designation acknowledges a critical shift from a purely medical model of health care to a focus on linking primary care with wellness, prevention, self-management, education and management of conditions and community services. Ridgeview’s Care Navigators increase care coordination by collaborating between primary care providers and community resources to provide quality-care within the communities served.

Insurance Coverage for Care Management Services

Your provider may recommend working with Care Management to help you manage your health. Because insurance coverage varies by plan, we encourage you to contact your insurance company to learn how these services would be covered under your benefits.