Resources to Guide your Professional Practice as a Case Manager

Resources to Guide your Professional Practice as a Case Manager

April 19, 2018

By Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN Nurse Advocate

As a professional Case manager, you have many resources that can assist you to practice in a safe, ethical and effective manner. This post will highlight a few of the resources you can use so that you are working in compliance with your area of practice.

We have an obligation to be aware of the laws and regulation that we are held to as licensed and certified professionals. Not knowing about laws, regulations, Standards of Practice and the Code of Professional Conduct is not an excuse you can use if you are called into a deposition or a court of law. These documents are out in the public domain so being aware of them and incorporating them into your practice is your responsibility as a professional. Let’s review.

First and foremost, all professionals are beholden to their professional licensure regulations for each state you are licensed. So for me, I am a licensed registered nurse in the State of Pennsylvania and Florida. It is my responsibility to understand my scope of practice in the states I am licensed. As we learned in the post, Nurses Working across State Lines: Are you Compliant? , you also need to know the rules if you work with clients outside of the states you are licensed and follow those rules.

Next are the dependent credentials - such as the national certifications of the Commission for Case Manager Certification (CCM), The American Case Management Association (ACM) and the American National Credentialing Center (RN-BC Nurse Case Manager) to name a few. Dependent credentials depend on your primary licensure, so if you lose your primary licensure and/or qualifying certification for any of the other certifications, such as the CCM, you will also lose your CCM.

Belonging to your professional organization is one of the ways you can stay up to date on the resources that are available to you to help ensure consumer safety and knowledge of best practices in your area of practice. In this post, I am going to focus on three documents that all Case Managers should be aware. Two are from the Case Management Society of America. The first is the Case Management Standards of Practice. The 2nd is the Case Management Model Act. Both documents are meant to be a unifying source for professionals who work in the area of Case/Care management. The Standards of Practice provide a common understanding and application of the role, process, and expectation of professional Case/Care managers. You can access the Standards of Practice for no cost at www.cmsa.org/sop

The Case Management Model Act was developed to define who Case/Care managers are and to show that there are specific education, experience, and competencies professional Case managers hold. The Model Act is used to educate members of Congress and other stakeholders about the profession of Case/Care management. You can read an article that was written on the Model Act in CMSA Today by clicking on this link. http://www.nxtbook.com/naylor/CMSQ/CMSQ1417/index.php#/12

If you are a Certified Case Manager through the Commission for Case Manager Certification, you are held to the Code of Professional Conduct. The Code of Professional Conduct provides the framework for all case managers to follow. Case Managers who carry the CCM Credential commit to providing ethical advocacy for their clients, putting the client’s safety, privacy and autonomy first. You can access the Professional Code of Conduct by this link; https://ccmcertification.org/sites/default/files/docs/2017/code_of_professional_conduct.pdf.

The Commission has written an issue brief, Foundational Principles: Newly revised Code of Professional Conduct Provides a framework for ethical, high-quality care. To access the Issue Brief, click here https://ccmcertification.org/sites/default/files/issue_brief_pdfs/23_-_updated_code_of_conduct.pdf

I encourage you to read these documents so that you are aware of the information. In addition, many organizations use these documents to develop policy and procedures to guide their departments. The documents also help you educate stakeholders on the role, function and value Case Managers bring to your organization and community. In addition, if your organizations have applied for accreditation from the various accreditation bodies, having these resources incorporated into your practice help you to meet Case Management standards that are found in accreditation standards.

I hope this information is helpful to you as a professional Case Manager as well as a member of the team at your organizations.

Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN

HEALTHCARE PRACTITIONER, LEADER AND EDUCATOR

Anne is a registered nurse with close to 40 years of experience in the healthcare industry. She holds a Master’s Degree in Training and Development from St. Francis University and a Bachelor in Health Services from Barry University. Anne is a board certified case manager through the American Nurses Credentialing Center and the Commission for Case Manager Certification. She is also a certified registered rehabilitation nurse through the American Rehabilitation Nursing Association. She is past President of the Case Management Society of America and also Governor for District 27 of Quota International. Anne is a frequent speaker both nationally and internationally on issues related to the practice. Anne is a co-author of Case Management Review and Resource Manual: published by the American Nurses Credentialing Center and now in its 3rd edition.

 

About Professional Services Network, Inc. 

Professional Services Network, Inc. (PSN) works with clients nationwide in the search and recruitment of experienced nurses in utilization review, quality and case management for temporary assignment and direct hire opportunities. Additionally, PSN’s consultants work with provider and managed care organizations seeking accreditation or re-accreditation with URAC or NCQA. For additional information regarding our services contact us toll-free at 877-753-1776 or email us at [email protected].