Case Management Nursing Career Resources

Case Management means responsibility for referral, consultation, ordering of therapy, admission to hospitals, follow-up care, and prepayment approval of referred services. It includes responsibility for relocating, coordinating, and monitoring all medical care on behalf of a patient. A case manager is a health care professional, who is employed to manage and coordinate complex medical cases to ensure quality and efficient use of health care resources.

Case Management is a service delivery approach now widely adopted across diverse settings in the human services and health sectors.
The best practices in Case Management require organizational arrangements to support service delivery, staff who have been trained for the approach and its application to the particular practice setting and strategies to ensure that the organization can be responsive to evidence from practice and advocate for systemic and policy change to support service delivery.

The principles that underpin Case Management are individualized service delivery based on comprehensive assessment that is used to develop a case or service plan. The plan is developed in collaboration with the client and reflects their choices and preferences for the service arrangements being developed. The goal is to empower the client and ensure that they are involved in all aspects of the planning and service arrangement in a dynamic way.

The Case Manager coordinates the process, consulting informal careers and key service providers to ensure that the plan is developed appropriately, clearly contracted and monitored for effective and financially accountable service provision based on specified and desired outcomes. The case manager and the organization are expected to maintain quality in service provision for individual clients and the wider target population.
In clinical settings the case manager may also provide specialist services to address particular needs of the client.

The Case Management approach assumes that clients with complex and multiple needs will access services from a range of service providers and the goal is to achieve seamless service delivery. This assumption highlights that the concept of Case Management is based in service provision arrangements that require different responses from within organizations and across organizational boundaries. Case management is described as a boundary spanning strategy to ensure service provision is client rather than organizationally driven.

Case Managers provide the coordinating and specialist activities that flow from the particular setting, program and client population. However it is usual to identify the following process as core to Case Management: screening, assessment/risk management, care planning, implementing service arrangement, monitoring/evaluation and advocacy.