The goal of this Blog is to provide information professionals and employers involved in medical management can use to meet the demands of today’s complex and disruptive healthcare system.

One writer who you will hear from is Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN, often referred to as the “the Case Manager’s, case manager”. She will share her expertise as a critical care nurse, case manager, nurse advocate and most recently a Brain Cancer Survivor. Anne will share information, tools and resources you need to have to work in today’s complex and disruptive healthcare system. We look forward to your comments, your suggestions for future posts and for your feedback on the opportunities and challenges you face as medical management professionals in today’s complex healthcare system. Please write to us at [email protected]

To kick off our first post, Anne shares a few resources that all professionals involved in the area of medical management should be familiar. If you are a case manager, a utilization review nurse or involved in quality, these resources should be reviewed and implemented into your professional practice as well as your organization’s policies and procedures. Take time to read them and share with your team.

Case Management Society of American Standards of Practice for Case Management. The Standards provides practice guidelines for the case management industry and its diverse stakeholders. In addition, these standards identify and address important foundational knowledge, skills, and competencies for the professional case manager within a spectrum of case management practice settings, specialties, and health and human service disciplines. The Standards were revised in 2016 to keep pace with the changing healthcare landscape. Feel free to download the Standards, review them and update your documents as needed.

Code of Professional Conduct for Case Managers. The Code of Professional Conduct for Case Managers was originally developed and adopted by the Commission for Case Manager Certification in 1996 and was last updated in 2015. If you are a certified case manager (CCM) you are held accountable to this Code. According to the CCMC website, the basic objective of The Code of Professional Conduct for Case Managers is to protect the public interest.  Accordingly, the Code consists of Principles, Rules of Conduct, and Standards for Professional Conduct, as well as the CCMC Procedures for Processing Complaints. The Principles provide normative guidelines and are advisory in nature.  The Rules of Conduct and the Standards for Professional Conduct prescribe the level of conduct required of every Certificant.  Compliance with these levels of conduct is mandatory and enforcement will be through the CCMC Procedures for Processing Complaints.

Reconnecting with the Past Presidents of the Case Management Society of America. This was an article that came out at the end of 2016 in CMSA Today, the official publication of the Case Management Society of America. The goal of the article was to share the voices of the Past Presidents of CMSA. In this article, the Past Presidents share valuable information that will empower you to work at the top of your profession. Whether you are working in a managed care organization, a hospital or other setting, the role of the professional case manager is critical for the patient, their caregiver and the healthcare team. Take a minute to read this article and share with your team.

All of us at PSN, recognize the important work being done in the area of medical management and we want to offer this medium to share best practices with you and your team so that you can better meet the needs of members, providers and other stakeholders.  If you would like to be interviewed or be a guest contributor to Managed Health Matters, please email Anne at [email protected] so she can schedule a time for you to talk.

Have a good week!

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 at 301-460-4089 or email us at [email protected].