A case manager oversees patients and patient care with a holistic view, and that makes it an excellent role for nurses. As a case manager, nurses advocate for patients as they establish care plans and coordinate care for cases that are often complex.

October 7 to 13, marks National Case Management Week and gives nurses a chance to learn about and explore this career path. A case manager role offers opportunities to make a difference in patient care, especially for patients and families who work with many caregivers.

According to the American Case Management Association (ACMA), case managers work with various physicians, nurses, caregivers, social workers, community resources, and patients to ensure access to needed services and resources. Then, they coordinate those resources to give the patients the best care options that also help meet the patient’s needs and desires.

A patient with several conditions, who relies on physical and occupational therapists, has home health care on certain days, takes multiple medications, and who is recovering from surgery is going to need a specialized care plan. This is where case managers are able to offer expert coordination. They keep an eye on each of the moving parts of the care plan.

With a nursing background, a case manager is able to watch for medical changes and anticipate potential care needs. The nursing expertise is valuable as a case manager, as nurses know how hospital and healthcare systems operate and also what patients need from providers. They are able to notice gaps in care that can make a difference in healthcare outcomes.

ACMA identified the following five core areas of a case manager’s role.

  • Education
  • Care coordination
  • Compliance
  • Transition management
  • Utilization management

Each area overlaps with others and involves many partners to succeed. The role is independent, but requires teamwork and collaboration for successful outcomes. Case managers take a broad view of the patient’s needs to ensure the patient and the patient’s family is fully informed. They explain the patient’s condition, the care needs that are presented, how they will be put into place, any additional screening or testing, and then a continuum of follow-up care to make sure the patient is receiving needed care.

Nurses in a case manager role gain immense career satisfaction from helping patients navigate the sometimes overwhelming healthcare system. Families are often grateful for the expertise case managers provide. Because they are so familiar with the healthcare system, they often know approaches or solutions families might not have access to. But case managers’ knowledge extends past the immediate healthcare system. They are able to help with emotional or mental health supports, home assistance, community resources, any necessary transition to facility assistance, and even spiritual resources.

Certification for case managers is highly recommended after at least one year of work in the field. If you are looking for a way to help patients and families in varied healthcare situations, a case manager role is an excellent way to do that.

Julia Quinn-Szcesuil

Julia Quinn-Szcesuil

Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.
Julia Quinn-Szcesuil

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