Case Management is the coordination of care and services for those individuals experiencing a catastrophic event, such as cancer or a condition causing disfigurement. It 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 while controlling costs.
Many individuals often have a combination of chronic conditions, mental health issues, and other issues requiring a case manager to assist them in their plan of care with various healthcare providers, insurance companies, Long Term Disability, Social Security Disability, community resources as well as their psychotherapist. Adriane and I often collaborate on several of our cases since patients receive both case management and individual counseling.
As a Nurse Case Manager, I use the nursing process to do a thorough intake utilizing a needs assessment when I receive a referral from a patient, caregiver, healthcare provider, or community resource. After the assessment, I collaborate with the various health care providers or community resources to implement or assist in the patient’s plan of care. The goal is to monitor and evaluate short-term and long-term goals to assist the patient in reaching their expected outcomes which are set with their healthcare providers.
Case Manager Job Responsibilities
- Accomplishes clients’ care by assessing treatment needs; developing, monitoring, and evaluating treatment plans and progress; facilitating interdisciplinary approaches.
- Determines clients’ requirements by completing intake interviews; determining the need for therapeutic medical, psycho-social, and psychiatric evaluations; reviewing therapist evaluations, treatment objectives, and plans.
- Establishes treatment programs by setting schedules and routines; coordinating services being provided; arranging resources, including transportation.
- Monitors cases by verifying clients’ attendance; observing and evaluating treatments and responses; advocating for needed services and entitlements; obtaining additional resources; intervening in crises; providing personal support.
- Maintains clients’ records by reviewing case notes, logging events and progress.
- Communicates clients’ progress by conducting weekly interdisciplinary meetings and evaluations; disseminating results and obstacles to therapeutic team and family; identifying treatment influences.
- Prepares clients’ discharge by reviewing and amplifying discharge plans; coordinating discharge and post-discharge requirements; orienting and training family members; providing resources.
- Meets budget by monitoring expenses, implementing cost-saving actions.
- Prepares reports by collecting, analyzing, and summarizing treatment and results data and trends along with compiling statistics.
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Featured image by Gabrielle Henderson on Unsplash