What is a Case Manager?
What is Case Management?
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 patient safety, quality of care, and cost effective outcomes. The professional case manager executes the process based on their scope of practice using critical thinking and evidenced-based knowledge.
Who are Case Managers?
Case managers are healthcare professionals who serve as patient advocates, supporting, guiding, and coordinating care for patients, families and caregivers as they navigate their health and wellness journeys. They serve as the center of communication, connecting individuals/caregivers with members of the healthcare team and community to impact acute and chronic disease management and improve population health.
How Can a Case Manager Help Me or Someone I Know?
Case managers can help people within the healthcare system understand:
- What they are going through
- What you need to do
- Why you need to do it
- Which resources may be available
- How to connect to information on insurance benefits
- How to manage day-to-day
- How to find the care you need when you need it
How Can I Find a Case Manager?
Case managers work at many places such as hospitals, health insurance companies, medical or mental health offices, outpatient clinics, doctor’s offices, home care, rehabilitation facilities – almost anywhere you receive care. All you need to do is ask, “can I speak with a case manager?”
Case managers are healthcare professionals who serve as patient advocates to support, guide and coordinate care for patients, families and caregivers as they navigate their health and wellness journeys.
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.