Author Archives: Deanna

2022 Case Management Salary and Trends Survey

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The Case Management Society of America (CMSA) and the Case Management Institute (CMI) have joined forces to continue our work on raising the awareness of case management and further developing its workforce.

Historically, CMSA has produced a biennial State of the Industry Report, while CMI has produced a Salary and Trends Report. With a common shared objective of providing key trends and benchmarks on the status of the professional practice of case management, CMSA and CMI are proud to present this combined report.

All Acute Care Case Managers  Need This!

All Acute Care Case Managers  Need This!

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Acute Care Case Managers Face a Unique Set of Challenges

We see the questions every day in our Case Managers Community Facebook Group.

Who should be receiving the Important Messages from Medicare (IMM)?
What is the proper use of Condition Code 44?
Who should be receiving the Medicare Outpatient Observation Notice (MOON)?
What are the rules and regulations regarding discharge appeals?
What are all the different Medicare notices/forms, etc to be aware of and understand?

Why Do Insurance Companies Lay Off Case Managers and How You Can Reduce the Risk

Why Do Insurance Companies Lay Off Case Managers and How You Can Reduce the Risk

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But first, you have to get the job!

Insurance companies hire based on the number of contracts they have. If they feel they will win new contracts and need more nurses for CM or UM or other positions, they will post for these positions.

If they get the contract they will hire. If they don’t get the contract they will stop the hiring process immediately. That is why many case managers get through the interview process thinking all went well, only to be told the position is not being filled.

Many of the very large companies that hire work from home case management positions all over the country have smaller “departments” or “lines of business”. So while one may be hiring, another may be laying off because they lost a contract. And while you would think they would just move people from one “department” to another. Often that is not the case, and those laid off will have to “reapply” for other positions.

Case Management Mentor: Be One, Have One

Case Management Mentor: Be One, Have One

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Mentoring is more than orientation and preceptorship. These focus on processes and procedures and have their place within an organization, ensuring employees are trained to fulfill their job duties. But mentorship goes beyond policies, procedures, and the “job”. It focuses on the whole person, their “career” as well as work-life balance. 

Mentorship is built on the relationship between the mentor and mentee and has the potential to create leaders. The best mentors see untapped potential in a colleague and help to develop that potential. They will challenge them to go outside of their comfort zone while providing encouragement, support, and direction that guides the mentee to grow into their full potential. 

Commitment, Communication, & Support

Commitment, Communication, & Support

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Everyone wants to hire a case manager with experience. Experience is very valuable, but with a large number of case managers reaching retirement age and the demand for case managers increasing, organizations will be forced to hire people who lack previous case management experience. And that’s not necessarily a bad thing. Bringing a fresh set of eyes into a department can have an incredible impact. 

We are going to look at one new case manager who had a major impact on her patients, department, and organization. We will look at the keys to her success and discover how this can be replicated in other organizations. 

Nursing Beyond the Bedside – Utilization Management and Utilization Review

Nursing Beyond the Bedside – Utilization Management and Utilization Review

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Utilization Management (UM) is one of the many nontraditional bedside jobs a nurse can pursue. In this article, we will look at what utilization management is and how to move into this position. 

Defining Utilization Management and Utilization Review

URAC (formerly the Utilization Review Accreditation Commission), a nonprofit organization promoting healthcare quality by accrediting healthcare organizations, defines utilization management as “the evaluation of the medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities under the provisions of the applicable health benefits plan.” Utilization management describes proactive actions such as discharge planning, concurrent review, and precertification. 

Foundations of Case Management

Foundations of Case Management

This course provides nurses with a general working knowledge of case management practices and the case management process preparing them to provide effective case management services in an appropriate, cost-effective manner which are consistent with CMSA Standards of Practice. This training will give case managers the firm foundation to build on with institutional policies and […]