Care Management
Comprehensive Support for Your Child’s Care
The Children’s Medical Services (CMS) Plan by Molina Healthcare offers case management services designed to support children and families with complex or ongoing healthcare needs. When your child enrolls, they are paired with a dedicated Case Manager — your primary point of contact for coordinating care, understanding benefits, and connecting to the right services.
Your Case Manager will partner with you, your child’s providers, community resources, and schools to make sure your child receives the services they need when they need them. If your child’s health, home life, or provider situation changes, your Case Manager will help update the care plan to keep support aligned with your family’s goals.
What Our Case Managers Do
Case Managers receive specialized training to support members with medical, behavioral, developmental, and social needs. Their role will include:
- Helping your family navigate medical, behavioral health, and pharmacy services
- Connecting you to social support programs such as housing and food assistance
- Coordinating school based services or accommodations
- Supporting access to Early Intervention services when needed
- Checking in regularly to make sure services are meeting your child’s needs
Care Coordination Support from CMS Plan Trained Staff
Our care managers will be trained to understand the unique challenges that Specialty members face. They will offer the highest quality of care.
Members and families will also get support through your team of specialists including Family Support Specialists, Educations Liaisons, Early Steps Specialists, Transition Coaches, Care Coordinators, and Health Educators.
Support for Youth Transitioning to Adulthood
CMS Plan will offer dedicated transition support for youth preparing to move into adult care. Our staff will help families plan for:
- Selecting adult healthcare providers
- Employment and vocational resources
- Community and housing supports
- Transportation
- Developing independent living skills
This service will include coaching, education, and guidance to ensure youth feel confident and supported as they gain independence.
Transitioning From Facilities to Home or Community
For children moving from a hospital, skilled nursing facility, or group home, transition specialists will be here to help. They will work closely with families and providers to evaluate options and create a safe, appropriate plan for returning home or moving into a community setting.
Need a Different Care Manager?
You will be able to request a change at any time by contacting Member Services (800) 262-0750 (TTY: 711). If CMS Plan needs to assign a new Case Manager for any reason, you will be notified.
When to Contact Your Case Manager
You will reach out anytime one of the following occurs:
- You have concerns about a service or provider
- Your child’s health or behaviors change
- Your child visits the ER or is admitted to the hospital
- A caregiver is no longer available
- Your child receives new health coverage
- Your address or contact information changes
Your Case Manager will be there to help—no issue is too small.
Pausing Services
If your child needs to temporarily pause a service, your Case Manager will walk you through the required steps and help complete any necessary forms.
Private Duty Nursing (PDN) Support
If your child receives Private Duty Nursing, your Care Manager will:
- Work with the home health agency to provide coverage
- Ensure staffing and services are provided as authorized
- Help you and your family connect with available benefits and services
In the event a shift is missed, it will be important for you to notify CMS Plan right away. Your Case Manager will:
- Contact the home health agency to understand coverage issues
- Work to ensure staffing and services continue as authorized
- Help you connect with another agency if needed
This helps us make sure your child remains safe and supported at home.
Disease Management Programs
We will offer disease management programs for children with chronic conditions like asthma, diabetes, hypertension, behavioral health concerns, cancer, and substance use disorders. Programs will provide:
- One‑on‑one coaching
- Education to understand and manage conditions
- Support with medication adherence
- Help following the plan of care
- Guidance in building healthy habits and coping skills
Earn Rewards for Healthy Activities
Families may earn rewards through CMS Plan’s Healthy Rewards Program by completing specific condition related activities such as:
- Smoking Cessation coaching (including vaping and chewing tobacco
- Adult and pediatric preventive care
- Weight loss coaching
- Alcohol or substance use coaching
- Pregnancy care
Rewards can be used for everyday expenses that support healthy living.
Children’s Medical Services (CMS) Plan by Molina Healthcare will provide managed care services to our members. Molina Healthcare is a licensed Florida health plan. CMS Plan will provide free aids and services to people with disabilities, such as qualified sign language interpreters, written information in other formats (large print, audio, accessible electronic and other formats), and free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages. This information will be available for free in other languages. Please contact Member Services at (800) 262-0750 (TTY: 711) Monday - Friday, 8:00 a.m. to 7:00 p.m.