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Case Managers Are…Case managers are the forefront of quality measures

Case Managers Are…Case managers are the forefront of quality measures

Case managers are at the forefront of quality measures in the clinic. From ensuring compliance with screenings to medication adherence, the entirety of a patient’s health is a priority. All people want a high-quality experience wherever service is rendered. Case managers are the key holders to drive the needle up in quality. What is high quality? From a case manager’s perspective, it means treating patients with the absolute best care just as if they were your own family member. Oftentimes, providers are consumed with paperwork and documentation requirements that there is just not enough time in the day to check if the next patient on the schedule is up to date on the wellness visit, screenings, vaccines, and to ask about memory concerns or fall risks. A simple screening questionnaire by the case manager can easily identify all the gaps in care and barriers to managing care. A quick conversation with the patient can also identify any need for intervention with memory concerns or falls. Let’s say a patient is a fall risk and is referred to physical therapy to improve balance. The simple referral for the patient could save thousands in hospital costs should they fall and become injured without the therapy. The autonomy of a certified case manager with a background in healthcare is invaluable and provides an additional resource to the clinic to drive up those quality measures.

Case Managers Are…Case managers are first, patient advocates

Case Managers Are…Case managers are first, patient advocates

Case management falls under the umbrella of the health and human services profession.  Its’ philosophy is based on the belief that everyone benefits when clients reach their optimum level of wellness, self-management, and functional capability (CCMC, 2022).  Oftentimes we find patients in the hospital without friends or family.  They are frightened and confused with all the information that is being thrown at them.  In their mind, the doctor is in a hurry and the nurses are scrambling around just trying to get through the day. They are afraid to ask questions, for fear of feeling like a burden.  It all seems like a whirlwind.  It is in this moment of chaos that the case manager can provide the patient with a sense of calmness.  Case managers can be the person that sits down with the patient and takes the time to answer their questions, all while making sure they do not feel rushed.  We can rest in the fact that we have provided clarity and understanding to a once unclear plan.  

Case managers are first, patient advocates, and it is our duty to ensure that each patient we encounter has equal access to proper healthcare and the resources and support they need to live the fullest life possible.   Our primary goal is to help our patients, and that includes supporting them and promoting their wishes.  Case managers are champions for our patients and families.  We find ourselves being interjected into a patient’s life during very vulnerable, and what may seem to them, hopeless times.  We are there to help them navigate these treacherous waters. 

Case Managers Are…Case managers are collaborators

Case Managers Are…Case managers are collaborators

Case managers are a difficult group to describe. We take on roles like a chameleon; ever-changing to meet the needs that are as complex as the populations we serve. Our role is often misunderstood, or even invisible to the professionals that rely on the work that we do. Our efforts are understated, yet incredibly important in assisting those that would be lost through the cracks.

I have often tried explaining what I do as a case manager but my descriptions never seem to do the profession justice. Our role is sometimes difficult to conceptualize because it falls into so many different categories and overlaps with multiple other professions. Most people I speak to are vaguely aware of the term but most are unaware of what a case manager does. Sometimes people will ask me if I am still a nurse. I’m not at the bedside dressing wounds or administering medications. I work at a computer and some days I stay in my pajamas all day, with Kitty slippers and all. Despite this, I am still a nurse. To be precise I am a nurse case manager. I am using my skills and working under a license just as I did before, only the work that I perform now is strictly mental and knowledge-based rather than procedural. I am using my experience and expertise to make sure that my clients are getting appropriate care, that they are taking the right steps to care for themselves, and that they know what to do when things fall apart. Of course, not all case managers are nurses. We are social workers and mental health specialists, among many other professions.

Case Managers Are…Case Managers are proponents of health maintenance and wellness

Case Managers Are…Case Managers are proponents of health maintenance and wellness

In Case Management, we “get to know” a person from a different perspective, far more than a simple lab test or a physical exam.
When a person works in the healthcare field, particularly the Case Management field, the aspects that go with it can be holistic, specialized, and focused. I remember when I first entered the Case
Management profession, a lot of people were asking me what I do again. Even Registered Nurses that I meet for the first time who have worked in bedside nursing for a while wanted a further explanation of
what I do because it creates curiosity within them. Defining what Case Managers do can both be simple and intricate depending on the audience and listener. In a simple definition, case managers can be
translated literally, which means “a person managing a case”. A bigger and more in-depth connotation can be best described as aiding people who have the greatest need. These needs may come from high-risk individuals, vulnerable populations, high utilizers of health care services, people who have been non-adherent to treatment, and people who need access to resources. Other times, the need may not
arise from the individuals mentioned above but also from healthy individuals who need assistance in sustaining their health, wellness, and vitality. With the rising cost of health care and the global
healthcare crisis, Case Managers are needed now more than ever.

Case Managers Are…Never the Same Day Twice

Case Managers Are…Never the Same Day Twice

A resident with a history of trauma asks for help finding a female dermatologist who accepts both Medicare and Medicaid so she will not have any out-of-pocket expenses – but not with this particular county medical group or any of their satellite clinics because they give horrible service. I run my Google-fu and find a couple of possibilities, but only if the resident’s primary care doctor can get prior authorization from Medicaid for the referral. I pass the information on to the resident and wish her the best of luck. 

When an aging veteran’s rep payee/caregiver takes the battery from his motorized wheelchair for three days as “punishment”, leaving the veteran unable to get to the grocery store or any food place to feed himself after previously only being able to carry 2-3 days’ worth of food home on his wheelchair at a time, I make the call to adult protective services. I also advocate with this resident’s external case manager numerous times over several months for a higher level of care due to the resident’s inability to meet his own needs in fully independent living and decreasing quality of life. The day before Thanksgiving, a substitute case manager filling in for the holiday week sees what I see and transfers him to the hospital, then finds him a place in hospice. My resident is literally dying while his primary case manager ignores or placates me for months; it took a substitute to hear and believe. The resident passes before the turn of the year but at least his last bit of time is comfortable.

Case Managers Are…Miracle workers, Peacemakers, and Multi-taskers

Case Managers Are…Miracle workers, Peacemakers, and Multi-taskers

1. Miracle workers: we pull rabbits out of hats we didn’t know had rabbits!
2. Peacemakers: we smooth out the roads between obnoxious uncooperative providers and our
injured workers, other providers, adjusters, claims examiners, team managers!
3. Bridges: we lay ourselves down like bridges over troubled waters to get our injured workers to
appropriate providers within days instead of weeks even when they’re not taking new patients,
back to work modified duty when their restrictions would prevent anyone else from even being
in the vicinity of a workplace, and back to society and their communities to enjoy life again!
4. Multi-taskers: we eat, drink, type our notes and reports, talk on the phone to injured workers
and doctors’ offices, organize our desks, pet our dog, and answer our spouse’s questions about
the weekend all at the same time!

Case Managers Are…Strength, intelligence, and sheer determination combined with creative thinking

Case Managers Are…Strength, intelligence, and sheer determination combined with creative thinking

Strength, intelligence, and sheer determination combined with creative thinking and sprinkled with empathy.  These are some of the most admirable traits of Marvels’ famous “Avengers.”  Comprised of those with sketchy criminal backgrounds combined with physical size and physical ability extremes, they work together to battle an unjust system to promote peace. 

However other, less famous professionals work together to battle a fragmented system embracing special populations with similar physical extremes.  These compassionate professionals creatively plan for those with similar interpersonal challenges.  Those superheroes call themselves another name; those superheroes call themselves case managers.

While superheroes are born of untimely misfortunes and accidents, case managers are remarkably similar with their evolution.  From childhood encounters with hospitals, to those thrust into caring for aging family members, ill pets and farm animals, their upbringing plunges them into healthcare.  Others simply manifest a passion to help those in need, and become driven to find their niche in the human services industry.  Their educational backgrounds vary from multiple advanced degreed social workers to similarly highly degreed registered nurses.  Their individual skillsets make them creatively resourceful, highly skilled and irreplaceable.  Experience is one of their most valued and hard earned assets to ensure success and longevity in the profession.

Case Managers Are…Really big strong birds that wear many hats

Case Managers Are…Really big strong birds that wear many hats

As a nurse case manager in the NY Workers Compensation arena, I must switch
my flight plan often.
I will be going to visit an injured worker at a MD office, and I hit NY traffic,
where I begin to sweat, hoping I make the appointment in time, and the tension of
the thought of missing the appointment, makes me grip the steering wheel so tight
that my fingers turn white. In my mind I am going 60mph. But the speedometer
says 15 mph. In this scenario I am a Peregrine falcon, as this is the fastest bird.
On another trip I will attend an injured worker’s bedside in the hospital, (over 100
miles from my office) that took a horrible fall and suffered bilateral calcaneus
fractures. He cannot go home because he will be non-weightbearing for months.
So, in I swoop to locate the best inpatient rehab facility, that is close to his home,
close to his family, negotiate a good rate for the insurance company, and make

Why Take a Prep Course Before You Sit For a Case Management Certification Examination?

Many ask, “should I take a prep course to help me pass the case management certification examination”? The answer is, that it depends. This article provides ten reasons why people take a prep course to help them prepare for their certification exam or any national examination that requires recall from various domains or practice. If these points resonate with you, check out the resources from the Case Management Institute to help you prepare as you step up to case management certification.

Salary for Case Managers

Salary for Case Managers

What is the Salary for Case Managers?

We are often asked about the salary for case managers. To answer this question The Case Management Society of America (CMSA) and the Case Management Institute (CMI) collaborated on a 2022 Case Management Salary and Trends Survey. 

The survey results show that most case managers (62%) earn a base salary of $80,000 or more. Over a quarter of case managers (27%) earn $100,000 per year or more. 8% make $130,000 or more annual base salary while only 7% of case managers reported a salary under $60,000. In addition, 84% of case managers’ salaries were listed at or above $70,000 per year. (Cooper-Gillingham et al., 2022)

Furthermore, 65% of case managers reported an increase in their salary over the last year and 85% of case managers are satisfied with the salary they receive. (Cooper-Gillingham et al., 2022)