At its heart, the job of a Private Nurse Case Manager is to be an all-around care coordinator. Just what that looks like in practice can be harder to define. The job entails many tasks and responsibilities. Also, there is not one definition of the job, because it differs from case to case and from specialty to specialty. It also varies depending on the setting in which the case manager works.
For example, a nurse case manager working in a hospital setting will have a different set of tasks and a much shorter length of involvement in a case than a private nurse case manager. In a hospital setting, a nurse case manager will oversee the coordination of services needed through the time of the hospitalization, and more often, at the time of discharge.
At that time, the work of care coordination is handed over either to family, the patient, or to an outside case manager, such as a private nurse case manager. The private case manager will stay with the patient to support and coordinate care throughout the patient’s injury, illness, or condition. In the case of an elderly patient, or younger person with a chronic condition or catastrophic injury, this can be for several years; possibly for the rest of their lives.
What Are Some of The Things That a Nurse Case Manager Will do?
By design a private nurse case manager is a more involved party; one who has the opportunity to work more closely and provide a sort of more wholistic care than many medical providers can. Their job includes monitoring and ensuring that all aspects of health and wellness, including physical, psychological, and social, are provided for–all the facets of a full life which can become unbalanced when one becomes a patient or suffers long-term, lasting, or chronic conditions.
The list of things that a nurse case manager might do is long and varied. To give you some idea, here is a list of 20 tasks and services that a case manager or care manager (as one might also be called) will provide:
- Assess patient and care needs based on orders from doctors, therapists, providers, home care and nursing services, the home environment, and availability of home and family support.
- Liaise between parties and providers, informing of the various services, progress, and treatments that are in place.
- Locate providers and services and assist with hiring of services and providers.
- Schedule appointments with all services and providers.
- Follow up on appointments and patient attendance.
- Arrange transportation to appointments.
- Attend appointments and/or oversee patient diagnoses and treatment plans.
- Explain diagnoses, treatments, and care plans for the patient and their family. Help to “translate” the medical language into understandable terms to help clients and family gain a fuller understanding of their condition, treatments, and the options available to them.
- Ensure care plans are implemented by providers.
- Evaluate care plans on an ongoing basis, oversee necessary changes and their implementation.
- Secure necessary medical equipment and durable medical goods.
- Assist with finances and management and use of insurance benefits and coverages.
- Identify additional available medical and social services and work to secure them.
- Contact insurers such as medical insurance providers or worker’s compensation insurers to make sure that clients/patients are paid and that their claims are paid according to their rights, benefits, and policies.
- Answer patient and family questions and address concerns.
- Assist in making medical decisions with the client (and family members if designated by the client).
- Arrange referrals for services and manage the filing and paperwork that is needed.
- Seek and obtain insurance approvals.
- Advocate for care and services on behalf of the patient.
- Communicate regularly with family members and advocates.
A Manager Whose Job It Is to Help the WHOLE Person, Know the WHOLE Story
In today’s very specialized medical environment, it can be difficult for individual providers to know all of the moving parts and contributing factors in a patient’s care and living situation. While doctors, primary care physicians, therapists (like physical or occupational or speech therapists), visiting nurses, home care services, and all the others involved in a patient’s care are all working to provide good care, few can know and understand the whole person and all that they are dealing with. They are tasked with providing one piece of care but are not as privy to all care and services as a case manager will be.
Having a dedicated professional who has the time and takes the time to know and understand all of these moving parts is a tremendous help. It can greatly impact the quality of life and outcomes for persons who are dealing with catastrophic conditions or who are unable due to their condition to understand and manage the often-overwhelming care that is involved in treating a chronic condition, serious injury, or mental conditions such as dementia or Alzheimer’s.
Case management can also be a tremendous help to family, lifting the burden of tracking and managing care for loved ones who work and have other life pressures, or for family who lives a distance away. This is the work of the nurse case manager—to be the one person who knows and brings all the various pieces, providers, needs, and services into line to make both the systems and the services work for the patient.
Collaboration, coordination, and communication are the three critical Cs of nurse case management. This is the umbrella under which a quality nurse case manager works to provide the best of care and services, with a focus on the best patient outcome possible.
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Private Home Care Services (PHCS) offers Care Management/Nurse Case Management, managed by qualified, certified nurses with training in case management. We have worked successfully alongside Case Managers assigned by insurers, facilities, and hospitals for many years, and we see an opportunity to better serve our clients and their families by offering this service in-house as a private case management service.
Because we are already at the forefront of care for our clients and patients, we know their needs, know the services they are receiving—or the services they should be receiving—and we are present to see the changes that need to be made to a care plan in real time.
To learn more about nurse case management at Private Home Care Services, click here:
https://privatehomecare.org/care-management/
Or Fill out a referral form:
https://privatehomecare.org/nurse-case-manager-referral/