Skip to Main Content

Members Empowered to Succeed (METS) Program

Date: 08/16/23

As a reminder, effective November 1, 2022, Superior HealthPlan implemented the Members Empowered to Succeed (METS) Program to support Medicaid (STAR, STAR Health, STAR+PLUS) and CHIP members with high behavioral health utilization needs.

METS takes a unique approach to member care. Partnering with the provider and member to ensure that the member achieves the ultimate level of recovery and resiliency. Clinical Liaisons work directly with providers to identify the member’s treatment and supports needed for successful progress in treatment, as well as assists with coordination of care when multiple providers are involved to ensure cohesive communication. Additionally, Member Engagement Coordinators assist with identification of resources to meet the member’s behavioral health, social and medical needs. Focusing on the member’s individualized needs creates a recovery roadmap that is as unique as the individual member.

The METS team includes:

  • METS Clinical Liaisons:
    • Have knowledge related to the member’s health plan processes and programs that can assist the provider in the utilization management process.
    • Are licensed clinicians with clinical and utilization management experience within managed care.
    • Review the member’s treatment records and collaborate with the provider for additional clinical information and support.
    • Develop a care strategy that best matches the member’s needs to the lowest acuity setting, taking into account the member’s goals and desired outcomes, with an emphasis on delivering high-quality care.
  • METS Engagement Coordinators:
    • Have knowledge related to the member’s health plan processes and programs that can assist the provider in accessing covered and available services.
    • Are skilled in motivational interviewing and identifying resource needs and will provide additional supports to members.
    • Partner with the Care Manager and member to make sure treatment aligns with the member’s personal goals, taking into account social determinants of health, health literacy and availability of community resources.

If you have questions, please contact Account Management Behavioral Health team at AM.BH@SuperiorHealthPlan.com.