What Is A Case Manager Or Nurse Case Manager?  

Nurse Case Manager on Computer in client home

Hiring A Private Care Manager Can Ease Burdens and Ensure Continuity of Care 

A Case Manager is a trained professional whose job it is to oversee and coordinate the care of patients in need of long-term care. This may be an elderly client living at home, an elderly client living in a care or assisted living facility, an injured patient following a workplace injury, trauma, or car accident, or a patient with a serious chronic condition. 

A Case Manager or Care Manager is one with experience in service and coordination; specifically, a nurse or a social worker. Not only do these professionals have experience and training to perform these duties, but they will also have a depth of knowledge in available programs, services, patient rights, and more. This knowledge is well beyond what the client/patient and/or family or friend advocate could expect to have.  

Who Hires a Case Manager? 

If you are familiar with case managers or case management, chances are it’s through an experience with a hospitalization. Nurse Case Managers are often a part of the care coordination and discharge process for patients. But case managers (or care managers as they are sometimes called) don’t just work in hospitals. 

Case managers may also be employed by insurance companies, by third-party case management consulting agencies, by nursing homes, care homes, or assisted living facilities. A case manager may also be a private case management provider. Just as there are personal care attendants and nurses who work privately for direct-pay clients, there are case managers and case management agencies who can be hired privately as well.  

How Are Case Managers Paid? 

How a case manager is paid depends primarily on who hired them and what they were hired for.  

Case managers that are hired by insurers are paid by the insurance company. A third-party consultant case manager will be paid by the company they work for, but that service will be contracted by the party in need—most often, an insurance company.  

In the case of a nurse case manager working as part of a hospital system, the manager will be paid by the hospital for which they work (but their role and responsibilities will end with the hospitalization/treatment).  

A private case manager is most often paid by the client, much the same as when a client or their family pays a private duty nurse, home health aide, companion, or personal care attendant. 

What Does a Case Manager Do? 

The scope of a case manager’s job is vast. It is also dependent upon the client’s case and also on the needs of the client. A short answer to this question is that a care manager coordinates all the different services and moving parts that are necessary to implement an effective care plan for the client or patient.  

Some of the tasks that case managers take over include:  

  • Appointment scheduling 
  • Scheduling of transportation if needed 
  • Building a comprehensive care plan 
  • Implementing the care plan 
  • Overseeing the service and providers that make up the care plan 
  • Securing equipment and supplies necessary for a patient’s treatment 
  • Liaising and advocating with vendors and parties such as insurers to make sure services are provided 
  • Liaising and advocating with physicians and their staff to arrange authorizations and schedule and coordinate treatments and services 
  • Communicate with family or designated advocates, keeping them up-to-date with the status of treatment and care plans, and informing them of adjustments being made to the plan 
  • Inform, educate, and advocate with and for the client so the patient knows what treatment options are available, and guide them as they decide the best course of treatment with their providers 

A case manager should be central to the care of the patient or client. The manager should be the one person who knows all of the pieces of the puzzle and helps fit them together. Though often this is a role that falls to a family member, it is a role that is overwhelming for family members to take on.  

Often family members simply do not have the time, resources, experience, access, or proximity to the patient and their providers to assume all the many parts of this role. This is where private nurse case management comes in. Acting in this way, a care manager can alleviate the stress on the family as they ensure the best care and outcome for the patient.

Professional Case Management at Private Home Care Services 

Private Home Care Services (PHCS) now offers Care Management/Nurse Case Management. While we have worked successfully alongside Case Managers assigned by insurers, facilities, and hospitals for many years, we saw 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.  

Additionally, because we have worked and continue to work with numerous providers and services, we are very well-versed and familiar with the very wide array of treatments, providers, facilities, and options that are available in our service areas. In fact, even though it is not always technically our responsibility, we have often found there is an overlap in the services we provide to our private care clients and that which should technically be managed by the care management team. Thus, it made good sense that we would streamline and expedite care, services, and positive outcomes by offering case management as a private in-house service.  

Taking all of this together, we at PHCS have decided that it is time for us to expand our services and offer private nurse case management and care management. We believe that our knowledge, professional relationships, contacts, and experience, along with our deep dedication to tailored, personal care, cost containment, and the best possible patient outcomes places us in a unique position to provide a seamless, coordinated, streamlined experience for our patients and their families.  

Please Contact Us to discuss how our private nurse case management services can benefit you or the important patient in your life. Know that when you put your or your loved one’s care in our hands, we will do our very best to coordinate the best possible care for the best possible outcome, with the comfort and well-being of you or your loved one as the absolute top priority. 

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/ 

Or Call PHCS: 

https://privatehomecare.org/contact-us/ 

 

Further Reading and Resources: 

https://youragingparent.com/hiring_a_case_manager.htm 

https://www.wgu.edu/career-guide/healthcare/nurse-case-manager-career.html#close 

https://www.purdueglobal.edu/blog/nursing/what-is-nurse-case-manager/ 

https://www.ahrq.gov/ncepcr/care/coordination/mgmt.html 

 

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