Organizing Medical Case Management

In the medical field, many people can be involved in your health care and recovery. It can get confusing trying to figure out who to talk to about what. Case management has made that easier. The case manager is the person responsible for assessment, planning, facilitation, care

Case management
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coordination, evaluation and advocacy for options and services to meet and individuals and family’s comprehensive health needs. The do their job through communication and available resources to provide quality cost effective outcomes. They plan, seek and monitor services for different social agencies and staff on behalf of the client. The do this in four steps. First, they get the referral of a new patient. The case manager then develops a plan for delivery of care. They evaluate the results for each patient and make adjustments where needed. Finally, they evaluate the overall program effectiveness. They function in several different areas. In the health care and HMO setting, their duties may include checking benefits and negotiating rates along with many other duties. In the health care provider setting, they will verify original benefits, coordinate services and provide post care follow-up but that is just a taste of their duties in that area. In the employee setting, they verify medical reasoning, follow-up after work absences and provide health education.