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Provider Manual

Programs for Members

Last Updated on February 19, 2026

Health Support for Members


Health Services Department 

Security Health Plan’s Health Services Department is staffed with medical directors, registered nurses, social workers, physical therapists, pharmacists, health educators, assistants and administrative staff who are responsible for the assessment, care coordination and management of the health care needs of our members.

Fair and Consistent Decision-Making    

Security Health Plan strives to make decisions that are reasonable, fair and consistent. Member needs, benefit plans, current medical evidence, national guidelines and stewardship of resources are all taken into account. If a request for medical services is denied based on medical necessity or because it is considered experimental/investigative, providers can discuss the case with Security Health Plan medical directors by calling the Provider Assistance Line at 1-800-548-1224. 

Care Management 

Security Health Plan’s care management services focus on each member’s specific health care needs. The care manager enlists the expertise of our medical directors, registered nurses, engagement associates, social workers, physical therapists, pharmacists and benefit/claims specialists along with providers, community resources and assistance programs to ensure our members receive the needed health care services and supplies according to their benefit plan. Care managers help individuals and families to effectively manage complex situations. 

Care management provides value to members for no added member cost by: 
  • Assisting members with complex health care needs such as newly diagnosed, progressive or advanced disease states, traumatic injuries, acute or chronic behavioral health conditions, high-risk pregnancies and ill newborns.
  • Contacting members following hospitalization for a significant health condition to ensure members have the knowledge and assistance needed to recover uneventfully and return to their previous level of functioning. Recommended follow-up is promoted and the risk of readmission is reduced.
  • Outreaching   members after they are discharged from a skilled nursing facility to quickly identify safety concerns, medication issues and/or problems with ADL and home management so that appropriate mitigating actions can be initiated.
  • Promoting preventive care and completion of advance care planning documents.
  • Coordinating referrals, including hospice and home health care services.
  • Addressing caregiver role strain and identifying available resources.
  • Supporting safe medication management.
  • Encouraging healthy lifestyle efforts and self-management skills.
  • Assisting members to navigate the health care system. 
  • Connecting members with community resources to address social determinant of health needs.

Physicians, other health care professionals, Security Health Plan staff, agents, members or family members may refer members for Care Management services by calling Customer Service at 1-800-472-2363 TTY 711. Security Health Plan staff also review  emergency room visits and health-risk assessments to identify members who would benefit from Care Management telephonic services.

Condition Management 

Security Health Plan’s approach to condition management emphasizes disease-specific education that promotes members’ self-management of their condition in partnership with their providers. Security Health Plan provides condition management for members with diabetes, asthma, heart failure, chronic obstructive pulmonary disease and coronary artery disease. Members receive education and telephonic coaching from an RN care manager and are guided toward appropriate self-management. The care manager encourages members to obtain recommended ongoing care and preventive services, recognize and report relevant signs and symptoms, adhere to the prescribed treatment plan (medications, diet, activity) and engage in healthy lifestyle practices. These services are provided  at no additional charge to members.

Program features: 
  • Convenient – We deliver assistance via telephonic, electronic contact and/or mailed information. The care manager works with the member to coordinate an outreach schedule.
  • Comprehensive – We focus on all the ways a member's condition affects their life.
  • Collaborative – We promote a collaborative relationship with the member, provider(s), care manager and other professionals.
  • Coaching – We use a motivational approach to promote behavior change for optimal health.
  • Individualized – We customize our approach based on an individual’s health needs and goals.
Program goals: 
  • Improve member health
  • Ensure high-quality health care
  • Change behavior and increase self-management skills
  • Empower members to effectively manage their condition
  • Prevent health complications
  • Contain health care costs

Online wellness programs

Security Health Plan members have access to online resources including WebMD through My Security Health Plan.
  • Health assessment  – asks basic questions about diet, exercise, sleep, health history and lifestyle. It creates a personalized action plan to help members improve their current health state.
  • Health coaches –  for telephonic support and advice.
  • Daily Habits  –   encourages setting small goals and tracking progress toward improving lifestyle behaviors and chronic conditions. Programs include Lose Weight, Cope with the Blues, Diabetes, Hypertension and many more.
  • Symptom Checker – an interactive symptom checker allows members to explore possible causes of symptoms and identify related treatments. 
  • Health Topics – provides in-depth information about specific health conditions such as depression, chronic fatigue and diabetes.
  • The Wellness at Your Side app  –  a convenient way to access WebMD programs and information from a smart phone or mobile device.
  • Videos  – offer information about emerging health trends.
  • Hundreds of healthy recipes with preparation tips and nutritional information.
  • Interactive health-related questionnaires and calculators.
Nicotine-Free program 
Security Health Plan supports members who want to stop using nicotine.  People who get support and education when quitting are more likely to be successful. We offer phone sessions designed to help members develop a plan to quit and discuss the following topics: 
  • Preparing to quit
  • Behavior, habits and addiction
  • Managing stress
  • Living a healthy life
  • Remaining nicotine-free 
Member advocate 
Security Health Plan’s member advocate is the contact person for members and providers who have questions, problems or grievances with the care received or coverage provided. The member advocate’s goal is to help members overcome barriers and assure they receive high quality, culturally sensitive care.

Contact information

Behavioral health/social workers
1-800-472-2363

Care management 
1-800-472-2363

Condition management 
1-800-472-2363

Medical directors 
1-800-548-1224

Member advocate
1-800-472-2363

Quality management 
1-800-548-1224

Utilization management 
1-800-991-8109

Wellness 
1-800-472-2363