Case managers help provide an array of services to help individuals and families cope with complicated situations in the most effective way possible, thereby achieving a better quality of life. They help people to identify their goals, needs, and resources. From that assessment, the case manager and the client—whether an individual or a family—together formulate a plan to meet those goals. The case manager helps clients to find resources and facilitates connection with services. Sometimes she or he advocates on behalf of a client to obtain needed services. The case manager also maintains communication with the client to evaluate whether the plan is effective in meeting the client’s goals.
A good case manager will work with you to determine what is important to you and what you think would be the most effective way to reach those goals. Case managers don’t manage people—they help people to manage complicated situations. Simply put, they help to keep you, or your loved ones, at the center of services being provided on your behalf.
Definition of Case Management
As defined by CMSA, case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.
Care management and care coordination are two other terms sometimes used to describe this work. Different organizations and individuals define these terms in different ways; for example, professionals providing services to older adults often call themselves geriatric care managers. The terms case management and case manager are often used for the sake of simplicity, but the information also applies to care management and care coordination.
Philosophy of Case Management
The underlying premise of case management is based in the fact that when an individual reaches the optimum level of wellness and functional capability, everyone benefits: the individuals being served, their support systems, the health care delivery systems and the various reimbursement sources.
Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source. Case management services are best offered in a climate that allows direct communication between the case manager, the client, and appropriate service personnel, in order to optimize the outcome for all concerned.
Certification determines that the case manager possesses the education, skills and experience required to render appropriate services based on sound principles of practice.
Where do Case Managers Work?
Case managers work in a variety of specialties, including health care, mental health care, addictions, long-term care, aging, HIV/AIDS, disabilities, occupational services, child welfare, and immigrant/refugee services. They are employed in the public, nonprofit, and for-profit sectors.
What Kind of Training, Certification, or License Does a Case Manager Need?
Case managers come from a variety of professional backgrounds and disciplines—including social work, nursing, gerontology, to name a few. They need to understand how to both work with individuals and families and navigate complicated service systems. Case Managers are trained to help people in the context of their unique social environments and are distinctly prepared to offer care services. In fact, the social work profession grew out of early case management work in the early 20th century, and social workers have remained active in case management since that time.
Certification is available in case management and specialty areas of practice, such as gerontology. Knowing a case manager is certified can help you to feel confident that you are working with a skilled, well-trained professional.