2019 - Best Practice Case Management Roles and Functions: How to Optimize RN and Social Worker Skill Sets

Introduction to the Standards of Practice
CMSA 2016 definition of case management
Statement of Philosophy
CMSA’s guiding principles for case management
Definition of a role
Role #1 Patient flow
Purpose and functions of patient flow
Goals of patient flow
Role #2 Utilization and resource management
Fundamental components of utilization management
Intersecting patient flow and utilization management
Resource management
Role #3 Denial management
Key functions of denial management
Shared roles
Role #4 Variance tracking
Functions within variance tracking
Goals of variance tracking
Role #5 Transitional and discharge planning
Discharge planning
Role #6 Quality Management
Quality management and the case manager
Role #7 Psychosocial assessment and counseling
Social work expertise
The social worker referral process
Integration of the roles
Summary of success