Who We Are

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Pathwise Case Management, LLC is a  organization dedicated to helping individuals, families, providers, and health plans navigate the healthcare system with clarity and confidence. Based in Georgia, we specialize in telephonic and community-based case management delivered by experienced registered nurses committed to improving outcomes, reducing avoidable utilization, and closing gaps in care.

We believe every person deserves a clear, supportive pathway to better health—one built on trust, compassion, and personalized guidance. Our mission is to connect patients, providers, and payers through proactive coordination, education, and advocacy that drives long-term wellness.

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Our Mission

To deliver patient-centered, data-informed care coordination that empowers individuals, enhances collaboration among care teams, supports health-plan quality goals, and removes barriers to accessing essential services.

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What We Do

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Pathwise Case Management provides comprehensive, outcomes-focused support across the care continuum, including:

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Telephonic Case Management

Proactive outreach, remote monitoring, follow-ups, medication checks, and wellness assessments conducted by skilled RNs.

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Care Coordination

Connecting members with primary care, specialists, behavioral health, community programs, and social support resources.

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Health Education & Coaching

Helping patients understand their diagnoses, medications, and self-management plans through clear, compassionate guidance.

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Chronic Disease Management

RN-led support for members with diabetes, hypertension, CHF, COPD, asthma, and other chronic conditions—improving stability and reducing preventable complications.

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Transitions of Care

Ensuring safe, structured transitions from hospital or skilled nursing facilities to home to reduce readmissions and promote continuity.

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HEDIS® Quality Measures Support

We partner with health plans to improve performance across key HEDIS domains by:

• Conducting targeted outreach to close care gaps

• Educating members on preventive screenings and follow-up needs

• Supporting medication adherence and chronic-condition monitoring

• Facilitating appointment scheduling and transportation coordination

• Providing data feedback to health plans and providers

• Addressing Social Determinants of Health (SDOH) affecting compliance

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Our HEDIS-focused program strengthens population health outcomes, improves quality scores, and supports value-based performance targets.

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Our Approach

At Pathwise, our model blends clinical expertise with data-driven strategies, delivering care that is both personal and purposeful.
We assess the whole person—not just their diagnoses—ensuring members receive the support, resources, and engagement they need to succeed.

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Why Health Plans & Providers Choose Pathwise

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Our Clinical Expertise

Our RNs bring extensive experience in chronic disease management, transitions of care, quality improvement, and population health.

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Customizable Care Plans

Every member receives an individualized plan addressing medical, behavioral, and social needs to support optimal outcomes.

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Quality & Compliance Focused

We align our workflows with HEDIS®, CMS, NCQA, and health-plan standards to support risk reduction, documentation accuracy, and quality performance.

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Seamless Collaboration

We work closely with providers, specialists, and hospitals to ensure care is coordinated—not fragmented.

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Compassion You Can Trust

We treat every member like family, offering support that goes beyond clinical data to address real-life challenges.

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Our Promise

At Pathwise Case Management, LLC, we don’t just manage cases—we build relationships that change lives.
Our promise is simple:

To deliver exceptional care coordination that brings peace of mind, improves outcomes, and supports the success of every patient and every partner, one individual at a time.