What do Nurse Case Managers do?
•We educate patients and consumers and collaborate with providers to utilize insurance benefits to provide cost effective care.
•Case managers are advocates who help patients understand their current health status, what they can do about it and why those treatments are important. In this way, case managers are catalysts; by guiding patients and providing cohesion to other professionals in the health care delivery team, we help clients achieve their healthcare goals more effectively and efficiently.

Definition of Nurse Case Management
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.
Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source. Case management services are in a climate of direct communication between the case manager, the client, and appropriate service personnel, in order to optimize the outcome for all concerned.

Client centered, evidence-based practice driven, collaborative, and timely care to meet your goals.

We work with:

•   Personal Injury

•   Workman’s Compensation

•   Disability Management

•   Catastrophic Injury

•   Catastrophic Illness

•   Life Care Planning

•   End of Life Care

•   Transitions of Care - any level of care

•   Oncology

•   Geriatric

Objectives:

•   Provides timely notification to all care team members and intervention to reduce the duration of your illnesses and injuries

•   Validates and monitors medically necessary work restrictions and accommodations

•   Increases Care Value through coordinated services

•   Reduces time-away-from-work cases through proper management

•   Facilitates referrals for a functional capacity evaluation for ADA and fit-for-duty cases

•   Facilitates a fair appraisal of life-time care needs and costs when appropriate

UM and UR incorporated – Standards of care individualized to You.

Reports within 24 hours to your providers.

Cost Effective – Outcome focused. 
Accessible 
we meet you where you are – on a case by case basis

•   Coordinates ongoing care with your care team throughout your episode of care.

•   Provides you and your family with community resource options.

•   Connects you with your cultural and age-specific-need resources.

•   Works with your insurance company to use your benefits correctly.

•   Assist you and your family through transitions of care.

Case Management works with you through all levels of care:

•             Tertiary Sub-Specialty Care or Facility

•             Intensive Care

•             Acute Care

•             L-TACH, a Long Term Acute Care Hospital

•             Acute Rehabilitation

•             Sub-Acute Rehabilitation

•             Home Health Care

•             Hospice Care – Home or Inpatient

•             Hospice

•             Skilled Nursing Care

•             Assisted Living

•             Long Term Care
Refer to Photo and comments on Gretchen from brochure on “About Us” – or “Providers” page.