What’s in a Name? Case Management Coordinators

Written by Terry Kennedy, Senior Search Consultant.
Contact her at 1.800.974.4828 x105, or terry@carenational.com

 

CareNational Healthcare Services already has an established reputation as the go-to resource for Medical Management staff, primarily licensed nurses and physicians. In a prior series of articles, we explored these clinical roles and duties for Case Management, Utilization ManagementQuality Management, and Reimbursement Management departments. Due to CareNational’s successful growth and expanding client base with both Managed Care Organizations and Hospital Systems nationwide, we established a Non-Clinical Division to accommodate recruitment and staffing needs for non-clinical Managed Care support services. We wanted to dedicate this series to exploring these non-clinical roles in more detail and facilitate a discussion on how that support fits into the greater umbrella of Health Care Services.

In Shakespeare’s Romeo & Juliet (Act II, Scene II) Juliet famously asks Romeo: “What’s in a name? That which we call a rose by any other name would smell as sweet.”

Operating coast to coast, and working with various types of payer and provider organizations, we have encountered a plethora of different terminology and titles for what are essentially comparable departments, functions, and individual roles. We wanted to look at different non-clinical positions and discuss the various titles, terms, and subsets of the discipline to see what you, the reader, had encountered in your education and experience.

First up are the Case Management Coordinators; they are non-clinical support staff responsible for administratively supporting the Nurse Case Managers, and sometimes Physicians, with a patient’s coordination of care. Sometimes these positions are titled ‘Care Coordinators,’ but it must be acknowledged that some organizations prefer to use the term ‘Care Coordinator’ when referring to clinical nurses (RNs or LPNs/LVNs) conducting Case Management activities, as they are essentially coordinating the care for patients or members amongst multiple specialists and healthcare resources.

Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.”
– CMSA Definition of Case Management

Non-clinical Case Management Coordinators play a critical role in the successful coordination of care. They generally work in tandem with the Nurse Case Managers and Social Workers to help facilitate the processing of cases and act as a conduit of information within the agency and outside resources within the community. While the nurse is the one who drafts the patient’s plan of care, it is the coordinator who often is engaging with the patient. Coordinators routinely review the care plan in order to assist the process by directing patients to available resources. They can also educate patients on a wide range of programs and options available to them including Urgent Cares or Flu Vaccination Clinics, which can ultimately result in fewer Emergency Room visits and inpatient acute care hospitalizations. This can facilitate effective Care Management across the Continuum of Care.

The responsibilities of a Case Management Coordinator can include reminding patients of preventative care checkups and even assisting the patient with scheduling of appointments with Primary Care Providers (PCPs) or Specialists. They will ensure that payer and providers have properly collaborated to resolve any payment issues. The Coordinator may even arrange transportation or other specialized assistance, if needed. While this administrative assistance may seem basic, it is transformative for providing value-based care, especially when considering the health management of chronic conditions.

Case Management Coordinators are often accountable for tracking the patient’s compliance with their physician’s orders and keeping the Case Management team informed when changes occur, such as Hospital or Skilled Nursing Facility (SNF) admissions. This can be done through traditional communications, such as phone calls and emails, or through more advanced TeleHealth options, such as remote monitoring of vital signs and other telemetry. The due diligence and documentation by the Case Management Coordinators helps streamline the work of the Nurse Case Managers monitoring the patients progress.
We are pleased to announce a special offer to accompany this discussion of non-clinical professionals in Health Care Service roles. For a limited time, we are giving away a FREE day of labor when you partner with us to find these non-clinical Managed Care specialists. Sign a contingent agreement (no associated fees unless you choose to hire a presented candidate) by August 1st, 2015 to take advantage of this promotional offer. Just click the below link for full offer details:

Written by Terry Kennedy, Senior Search Consultant. For an enjoyable discussion of clinical and non-clinical managed care roles, or to review our current opportunities, reach out to one of CareNational’s best Medical Management Recruiters! Contact her at 1.800.974.4828 x105, or email her at terry@carenational.com