Paragraph one: This essay will discuss the roles and responsibilities of case managers in the provision of health care.

Paragraph two: Case managers assess the client’s health and psychosocial needs.

Paragraph three:The Case manager comes up with the case management plan in liaison with the client and other key playersin order to optimize healthcare quality and cost effective outcomes.

Paragraph four:Case managers educates all members of the case management team on various aspects of the case. In addition, he or she ensures proper implementation of the plan.

Paragraph five:Case managersmonitor and evaluate the implementation of the case management plan.

Paragraph six:Case managers advocate for the client and the payer in order to realize positive outcomes.

Paragraph seven: This essay has discussed the roles and responsibilities of case managers.

Case management concepts encompass coordination of quality services so as to address the needs of clients in a cost-effective way in order to promote desired outcomes(National Association of Social workers [NASW], 2007). The roles and responsibilities of case managers can either occur in a single or multiple health care setting. On the other hand, this can occur when the client goes through the healthcare continuum. In short, a case manager plays an essential role as a facilitator among the caregiver or the client, family, the health care team, the payer, and the community as a whole. As far as the clients who need care is concerned, the case manager has got many roles and responsibilities. This is because case management is a process that involves assessment, planning, coordination of care, facilitation, and evaluation as well as advocacy for services and options that meet the needs of the client(National Association of Social workers [NASW], 2007). this essay will discuss the roles and responsibilities of case managers in the provision of health care.

It is the responsibility of a case manager to assess clients so as to establish their health and psychosocial status. The assessment goes all the way to health literacy status and deficits. According to Tahan, Huber, and Downey (2009), case management involves conducting comprehensive assessments for clients’ health and psychosocial needs among many others. More so, the case manager doesn’t stop at that point. He or she goes ahead to a case management to develop a case management plan in liaison with the client and the family as well as the caregiver.Yoder-Wise (2014)asserts that case managers have an essential role in the provision of care since they screen and assess the client needs through the analysis of the available information, which results in the professional judgment of risks, needs, and strengths.

Thereafter, the case manager plans with the client, his or her family, caregiver, the care provider, other care providers, the payer, and the community as a whole. The planning aims at maximizing the health care quality and cost effective outcomes. Case planning is key in determining the goals and objectives of care(Fairman, Rowe, Hassmiller, & Shalala, 2011). Such involves the identification of strategies to address the emotional, social, and physical needs of the client. Since this is an interactive process, all the stakeholders should play their respective role under the influence of the case manager.In the whole process of planning, the manager facilitates coordination and communication of the case management members such as the client and the care provider in order to therapeutic decisions.

Furthermore, the responsibility of educating the client and members of the health care team on numerous matters is the work of case managers. The education dwells on matters community resources, treatment options available, case management, insurance benefits, and psychosocial concerns(NASW, 2007). The aim of this is to ensure that quality decisions are made on an informed and timely basis. In doing all this, the main role is to implement the case management role. That is through the delivery or arrangement of case management services with the use of the readily available resources so as to meet the case plan goals. in doing this, the client communicates with the case manager to ascertain if the needs are being met as planned.

Most cases can fail to advance as intended because of monitoring challenges. It is the responsibility of the case manager to ensure that he or she obtains the feedback not only from the client, but also from the care providers in order to determine if the plan is being executed by the plan(Vanderplasschen, Wolf, Rapp, &Broekaert, 2010). The process of monitoring cannot go on its own without evaluation of the strategies being implemented. The case manager is endowed with the responsibility of evaluating whether the laid down goals and objectives have been met or not and if there is a need to change the plan because of the changing needs of the client. In the case that the needs have changed, the case manager goes ahead to facilitate the whole process of case management from the beginning.

Finally, the case managers have the role of advocating for the client and the payer in order to enhance positive outcomes. Tahan, Huber, and Downey (2009)reiterates that when case managers advocate for the client and the payer, the case management outcomes are often positive. In the case of a conflict, the rights and needs of the client are prioritized.Once all the roles and responsibilities are played well, the case manager can close the case at the most relevant time. That is when the intended goals and objectives have been met and the client’s problems have been solved.

In conclusion, case management is a process that involves assessment of the needs of the client, planning and coordination of care, facilitation, evaluation and advocacy for the services and options meeting the client’s needs. The case managers have several roles and responsibilities in enhancing the success of the entire process. Case managers have the roles and responsibilities in assessing the client, planning the case management services with the client and other members and implementing the plan. Furthermore, case managers have the role to monitor and evaluate the execution of the laid down plans. Most importantly, case management must involve the role of client and payer advocacy to enhance positive outcomes.

References

Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of nursing practice. New England Journal of Medicine, 364(3), 193-196.

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models of case management for substance abusing populations. Journal of Psychoactive Drugs, 39, 81–95.

National Association of Social workers [NASW] (2007). Standards of Practice

Tahan, H., Huber, D., & Downey, W. (2009). Case Managers’ Roles and Functions: Commission for Case Manager Certification’s 2004 Research, Part I. Lippincott’s Case Management, 11(1), 4-22.

Vanderplasschen, W., Wolf, J., Rapp, R. C., &Broekaert, E. (2010). Effectiveness of different

Yoder-Wise, P. S. (2014). Leading and managing in nursing. Elsevier Health Sciences.