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Become A Case Management Specialist

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Working As A Case Management Specialist

  • Getting Information
  • Documenting/Recording Information
  • Organizing, Planning, and Prioritizing Work
  • Communicating with Supervisors, Peers, or Subordinates
  • Performing for or Working Directly with the Public
  • Deal with People

  • Unpleasant/Angry People

  • Stressful

  • $38,280

    Average Salary

What Does A Case Management Specialist Do At Covenant Healthcare

* Demonstrates excellent customer service.
* Contributes to organizational success targets for patient satisfaction by meeting the Case Management Specialist expectations for Customer Satisfaction.
* Contributes to organizational success targets for net operating margin.
* Contributes to organizational targets for length of stay reductions overall and for Hospital Medicine.
* Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.
* Ensures the availability of accurate and timely information.
* Demonstrates age specific competency in the selected age groups: newborn, infant, pediatric, child, adolescent, adult, and geriatric.
* Collaborates in the development, revision and evaluation of a multidisciplinary plan of care by continuously assessing patient and family needs from pre-hospitalization through post hospital services.
* Initiates and manages transitions when the patient experiences the need for new and different services.
* Collaborates with and uses support of Social Worker regarding cases with complex social service needs.
* Case Management admission assessments must be accomplished as soon as possible after admission to the facility Collaborates with physicians and all other members of the multidisciplinary team to facilitate and ensure continuity, timeliness and appropriateness of care for designated case load; monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; and ensures timely: completion and reporting of diagnostic testing; initiation and completion of treatment plan; initiation and completion of transition plan; and completion of all required documentation.
* Reviews cases for quality or risk management issues and intervenes when indicated.
* Refers Class II quality issues to appropriate physician liaison.
* Documents issue and intervention in MIDAS+ database.
* Performs concurrent variance monitoring and works collaboratively to effectively resolve the variance.
* Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management.
* Prepares, issues, distributes, and tracks notices of non-coverage Facilitates multidisciplinary care conferences as needed for complex cases.
* Ensures that all elements critical to the patient pathway have been communicated to the patient/family.
* Facilitate and coordinate transfers of patients to other facilities Maintains an understanding of reimbursement methods.
* Identifies patients with potential for extended length of stay or variances and collaborates with multidisciplinary team to develop interventions to correct the issues.
* Monitors cost-effective care, therefore, preventing duplication or fragmentation of care and curtailing operational and clinical delays.
* Evaluates effectiveness of interventions on outcomes that measure cost and quality such as LOS and variances from expected outcomes.
* Interprets patient response and collaboratively identifies interventions to maximize positive outcomes.
* Works with the Healthcare team to demonstrate fiscal responsibility by being conscious of the need to appropriately use the resource dollars available and identify and pursue opportunities.
* Participates in the development, implementation, and analysis of care paths or clinical algorithms related to a specific patient population.
* Helps to implement standards of care, standards of practice, hospital policies and critical pathways.
* Through case management efforts, assists in meeting all accreditation and licensing processes.
* Actively prepares and participates in accrediting agency surveys.
* Assists in planning, implementing and evaluating quality improvement.
* Works with the CRM Department to optimize patient outcomes.
* Admission and continued stay reviews will be accomplished on all patients regardless of payor as needed.
* Demonstrates excellent communication skills, negotiation skills, diplomacy and assertiveness.
* Builds and nurtures professional, effective relationships with all members of the Healthcare team.
* Manages conflict effectively, striving for win-win outcomes.
* Serves as a patient and family advocate.
* Is aware of the patient's diagnosis, prognosis and insurance benefits available.
* Works to maximize positive outcomes.
* Serves as a resource to the health care team related to discharge planning, utilization management, case management and patient pathways

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How To Become A Case Management Specialist

Requirements for social and human service assistants vary, although they typically have at least a high school diploma and must complete a brief period of on-the-job training. Some employers prefer to hire workers who have additional education or experience.

Education

Although a high school diploma is typically required, some employers prefer to hire workers who have relevant work experience or education beyond high school. A certificate or an associate’s degree in a subject such as human services, gerontology (working with older adults), or social or behavioral science is common for workers entering this occupation.

Human service degree programs train students to observe and interview patients, carry out treatment plans, and handle people who are undergoing a crisis. Many programs include fieldwork to give students hands-on experience.

The level of education that social and human service assistants have completed often determines the responsibilities they are given. Those with a high school diploma are likely to do lower level work, such as helping clients fill out paperwork. Assistants with some college education may coordinate program activities or manage a group home.

Although postsecondary education is important, some employers may prefer or allow for applicants who have related work experience. In some cases, candidates may substitute such experience in place of postsecondary education. 

Training

Many social and human service assistants, particularly those without any postsecondary education, undergo a period of on-the-job training. Because such workers often are dealing with multiple clients from a wide variety of backgrounds, on-the-job training in case management helps prepare them to respond appropriately to the different needs and situations of their clients.

Advancement

For social and human service assistants, additional education is almost always necessary for advancement. In general, advancement to case management or social work jobs requires a bachelor’s or master’s degree in human services, counseling, rehabilitation, social work, or a related field.

Important Qualities

Communication skills. Social and human service assistants talk with clients about the challenges in their lives and assist them in getting help. These workers must be able to listen to their clients and to communicate the clients’ needs to organizations that can help them.

Compassion. Social and human service assistants often work with people who are in stressful and difficult situations. To develop strong relationships, they must have compassion and empathy for their clients.

Interpersonal skills. Social and human service assistants must make their clients feel comfortable discussing sensitive issues. Assistants also need to build relationships with other service providers to become familiar with all of the resources that are available in their communities.

Organizational skills. Social and human service assistants often must complete lots of paperwork and work with many different clients. They must be organized in order to ensure that the paperwork is filed properly and that clients are getting the help they need.

Problem-solving skills. Social and human service assistants help clients find solutions to their problems. They must be able to listen carefully to their clients’ needs and offer practical solutions.

Time-management skills. Social and human service assistants often work with many clients. They must manage their time effectively to ensure that their clients are getting the attention they need.

Some employers require a criminal background check. In some settings, workers need a valid driver’s license.

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Case Management Specialist jobs

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Case Management Specialist Demographics

Gender

  • Female

    77.2%
  • Male

    20.5%
  • Unknown

    2.3%

Ethnicity

  • White

    79.8%
  • Hispanic or Latino

    11.1%
  • Asian

    6.2%
  • Unknown

    2.4%
  • Black or African American

    0.5%
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Languages Spoken

  • Spanish

    59.1%
  • Carrier

    6.8%
  • Chinese

    4.5%
  • German

    4.5%
  • Swahili

    2.3%
  • Portuguese

    2.3%
  • Somali

    2.3%
  • French

    2.3%
  • Amharic

    2.3%
  • Czech

    2.3%
  • Tagalog

    2.3%
  • Mandarin

    2.3%
  • Arabic

    2.3%
  • Korean

    2.3%
  • Italian

    2.3%
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Case Management Specialist

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Case Management Specialist Education

Case Management Specialist

Unfortunately we don’t have enough data for this section.

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Real Case Management Specialist Salaries

Job Title Company Location Start Date Salary
Physician Advisor/Case Management Northampton Hospital Company Easton, PA Aug 01, 2015 $229,570
Physician Advisor/Case Management Northampton Hospital Company Easton, PA Jul 09, 2015 $229,570
Rehablitation Case Management Specialist RN Villa Care Center LLC Portland, OR Oct 07, 2011 $68,934
Care Case Management Specialist NMS Healthcare of Hagerstown Annapolis, MD Jun 30, 2011 $66,208
Care Case Management Specialist NMS Healthcare of Hyattsville Hagerstown, MD Nov 09, 2011 $65,790
Case Care Management Specialist NMS Healthcare of Hyattsville LLC Hyattsville, MD Jan 03, 2011 $65,790
Care Case Management Specialist NMS Healthcare of Hyattsville LLC Hyattsville, MD Oct 01, 2010 $65,790
Insurance Reporting & Case Management Specialist Towers Watson Delaware Inc. Arlington, VA Sep 21, 2012 $65,000 -
$75,000
Care Case Management Specialist New Annapolis Nursing, LLC Annapolis, MD Feb 01, 2011 $64,480
Care Case Management Specialist NMS Healthcare of Hagerstown, LLC Hagerstown, MD Dec 15, 2009 $64,480
Care Case Management Specialist Heritage Care, Inc. Hyattsville, MD May 01, 2010 $64,480
Care Case Management Specialist Heritage Care Inc. Hyattsville, MD Mar 05, 2010 $64,480
Care Case Management Specialist NMS Healthcare of Hyattsville, LLC Hyattsville, MD Oct 01, 2009 $63,565 -
$113,069
Care Case Management Specialist Heritage Care, Inc. Hyattsville, MD Sep 09, 2010 $63,565 -
$64,480
Care Case Management Specialist Heritage Care, Inc. Hyattsville, MD Oct 01, 2009 $63,565 -
$80,059
Insurance Reporting & Case Management Specialist A Watson Wyatt & Company Arlington, VA May 21, 2010 $61,547 -
$65,820
Care Case Management Specialist Universal Medical Records Information Network Corp Cortlandt, NY Sep 20, 2010 $60,000
Case Care Management Specialist Professional Resource Enterprises, Inc. San Francisco, CA Oct 01, 2012 $58,707
Care Case Management Specialist NMS Healthcare of Hagerstown, LLC Hagerstown, MD Oct 01, 2009 $58,000 -
$64,480
Care Case Management Specialist United Nursing International, LLC. Los Angeles, CA Sep 27, 2010 $57,325
Care Case Management Specialist Professional Resource Enterprises, Inc. San Francisco, CA Oct 15, 2010 $55,827
Care Case Management Specialist Heritage Care, Inc. Hagerstown, MD Sep 15, 2009 $54,704 -
$66,373
Care Case Management Specialist Heritage Care, Inc. Hyattsville, MD Sep 07, 2010 $54,704 -
$64,480
Care Case Management Specialist NMS Healthcare of Hagerstown, LLC Hagerstown, MD Sep 16, 2009 $54,704 -
$66,373
Care Case Management Specialist NMS Healthcare of Hagerstown, LLC Hagerstown, MD Oct 01, 2009 $54,704 -
$66,373

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Top Skills for A Case Management Specialist

ProvidersProceduresIntakeInterviewsMentalHealthServicesTreatmentPlansCustomerServicePolicyDisabilityClaimsCommunityResourcesDataEntryMedicaidAdditionalSubstanceAbuseMedicalRecordsSupportServicesServicePlansCarePlansAlcoholDischargePlanningCommunityAgencies

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Top Case Management Specialist Skills

  1. Providers
  2. Procedures
  3. Intake Interviews
You can check out examples of real life uses of top skills on resumes here:
  • Manage relationships with community partners and training providers to identify most suitable education options for customers.
  • Recommend and update operational processes and procedures
  • Advocated for improved mental health services with psychiatric, community, and government individuals and organizations.
  • Developed and implemented master treatment plans based on diagnosis and identified other psychosocial needs.
  • Assigned to reorganize operational procedures for new division to enhance customer service and quality assurance.

Top Case Management Specialist Employers

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Case Management Specialist Videos

Case management

Case Manager, Career Video from drkit.org

Career Advice Audiobook Sample | Becoming Generation Flux | Successful Career Planning

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