Case Managers

Written by Kimberly Clark
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The Centers for Medicare & Medicaid Services (CMS) defines the term case manager as "a nurse, doctor, or social worker who arranges all services that are needed to give proper health care to a patient or group of patients." As anyone in the healthcare industry well knows, the treatments provided to patients these days are by no way limited to those performed in the doctor's office. On the contrary, today's healthcare field encompasses a wide range of services from home healthcare to rehabilitative therapy, which is why more integrated software solutions are becoming not just convenient, but quite necessary.

The position of case manager was basically created to keep up with the many different facets of the healthcare field. The case manager's primary function is to make sure each patient receives the necessary care required for their personal recovery. In addition, the case manager is also assigned the responsibility of ensuring that their patient is fully aware of all available treatment options and has access to every feasible healthcare resource.

Instead of serving as an advocate for patient's rights, some case managers work on behalf of private health insurers or government healthcare plans, such as Medicaid. They are generally brought in by the healthcare plans when a patient's care requires extensive and high-priced treatments. In these instances, the case manager's main goal is to assure that the treatments offered are at the lowest possible cost while still providing the patient with the best quality of care.

Case Manager Certifications

There are several organizations that provide support as well as continuing education to their respective case managers. In addition, many of the associations offer various certifications to its qualified members. For example, the Commission for Case Manager Certification (CCMC) offers the Certified Case Manager (CMC) credential, whereas the National Association of Social Workers (NASW) issues the Certified Social Work Case Manager (C-SWCM) accreditation.


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