Case Management

Case managers are typically nurses and social workers who work in for-profit organizations such as hospitals and health insurance companies to develop treatment plans of care for patients that are designed to minimize costly readmissions. They do this by assessing patients’ needs from a variety of perspectives, including medical, financial, social, and behavioral, and then attempt to address identified issues that can also interfere with adherence to their medical providers’ prescribed plan (medications, diet, etc.) once the patient is discharged.

But what happens once the patient is discharged? Often times the patient and their families are left to navigate on their own the barriers to remaining independent in their home. Sometimes, the patient’s health insurance company will identify them as a high risk for readmission claims and assign them to their case management department for periodic calls and assessments. However, due to the case manager’s high caseload, creating agreeable plans of care patients want to adhere to that the case manager can follow-up on in an effective and timely manner is impossible. More often, patients don’t trust the case manager calling from their insurance company and don’t feel comfortable discussing issues/needs they have with them.

I understand these concerns because I’ve worked as a medical social worker and case manager in these environments for over 20 years. Because I’m an I dependently licensed social worker and board-certified case manager, I’ve advocated for my patients within the organizations that employed me when my assessment of their needs conflicted with the organization’s policies (to pay for needed services that were previously denied, for example). When you work with me privately, or hire me to work with your loved one who lives here locally, you’ll know that my interests are aligned with your own, rather than with an insurance company or hospital discharge department. You’ll also receive a more comprehensive assessment of, and attention to, your psychosocial needs (barriers to independence if unaddressed) than home health agencies are able to provide because I limit the number of patients I accept under this program.

Click on the badge below to verify my case management certification credential, review my “About Me/Contact” page, or call me for more information on this service.