Case Manager


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BASIC DESCRIPTION

Case management is the process of organizing and coordinating resources and services in response to individual health care needs along the illness and care continuum in multiple settings. There are many models for case management based on client, context, or setting. The nurse case manager assesses and monitors clients and the health care delivery services that they require. Case management is directed toward a targeted or selected client/family population such as transplant, head-injured, or frail elderly clients. The goals are to center services around the patient, to foster patient self-managed care, and to maximize efficient and cost-effective use of health resources. The focus is cost saving and continuity of care. Case managers have the opportunity to work in hospitals, community outreach, clinics, occupational health, insurance companies, and health maintenance organizations.

EDUCATIONAL REQUIREMENTS

Registered nurse preparation and Bachelor of Science in Nursing are required; master’s degree is preferred; certification in case management is available from the American Nurses Credentialing Center.

CORE COMPETENCIES/SKILLS NEEDED

■ Strong knowledge base in both the financial and clinical aspects of care
■ Understanding of community resources
■ Strong communication skills
■ Effective skills in managing, teaching, and negotiating
■ Ability to work with interdisciplinary groups
■ Ability to focus on patients and families

RELATED WEB SITES AND PROFESSIONAL ORGANIZATIONS

■ The American Association of Managed Care Nurses (www.aamcn.org)
■ Commission for Case Manager Certification (www.ccmcertification.org)
■ Case Management Society of America (www.cmsa.org)

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