Case Management Chapter 2: Essential Case Management job responsibilities and skills Flashcards
Optimal outcomes of case management
quality care, access to healthcare, cost-effective, provider and payor satisfaction, patient and family advocacy
Undesired outcomes of case management
- patient/family dissatisfaction (lawsuit potential), grievances, fragmented care, adverse outcomes, costly and inefficient, role conflict and frustrated professionals
Roles and responsibilities of case managers
Patient advocate, protector of privacy and confidentiality, case screening expert, coordinator of care, assessing, reassessing and reassessing, discharge planner and facilitator in level of care changes, follow-up and follow-through, utilization manager, knowledge of insurance structures, cost-benefit analyst, disease management expert, negotiator, professional, team player, strong interpersonal communication skills, assertive, coach, conflict resolution, ability to prioritize, documenter of plans, orgainizational skills, leadership and management skills
Case manager’s leadership roles
make others feel important, promote a vision, follow golden rule, admit mistakes, praise others in public, stay close to the action, get entire story before making decision, focus on what is right- not who is right, develop plan and execute effectively, think and act in a goal-oriented manner.
Case manager’s personality traits
- caring attitude, sensitivity (particularly cultural), resourcefulness, commitment, creativity, autonomy, emotional intelligence, self-directedness, assertiveness, risk-taking, sense of humor, respect
3 approaches to training and education of case managers
On-the-job training, continuing education, graduate level
Topics for case management education program:
Case Management Process, Case Management Roles and Functions, Case Management Models, Utilization Management, Legal Issues, Ethical Issues, Outcome Measurement, Negotiation, Information Systems, Research
