What Does a Care Managers Do?

11 Jan 2022
Discover what a care manager does, their crucial role in enhancing care for children with disabilities.

Understanding Care Managers

Navigating the world of healthcare for children with disabilities can be overwhelming. This is where care managers come in. They act as an invaluable aid, helping to ensure the child receives the necessary medical care and support services.

Role of a Care Manager

A care manager is a professional who creates customized care plans for patients based on their unique needs. Their responsibilities include collaborating with the family of patients, monitoring patient recovery, and helping patients gain access to different health providers as needed. In the context of children with disabilities, this might involve liaising with social workers, speech therapists, and occupational therapists, among others.

Additionally, care managers ensure that patients follow-up with their primary care providers and coordinate appropriate services. They are also involved in providing patient education and ensuring accurate medication reconciliation, all of which can have a significant impact on clinical outcomes.

Care managers are usually expected to be involved in most aspects of wellness programs, including fulfilling specific duties and expertise to meet program requirements.

Importance of Care Managers

The role of a care manager is crucial in the value-based care and wellness programs. They ensure these programs' success by coordinating care and working with a large group of people, including the patients, their families, and the healthcare providers [3].

Care managers build effective relationships with patients, which is believed to improve patient outcomes most significantly. All care managers believe that relationships with patients have the greatest impact on patient satisfaction, while the support they provide clinicians has the greatest impact on clinician satisfaction.

With their vast responsibilities, time management is a vital skill for care managers, who might coordinate services among a large number of patients, sometimes up to 250 patients per month.

In conclusion, care managers play a pivotal role in managing the holistic care of children with disabilities. Their work ensures these children receive the necessary care and support, ultimately improving their quality of life.

Skills and Responsibilities

Understanding the role of a care manager goes beyond simply asking "what does a care manager do?". It involves understanding the diverse skills they possess and the varied responsibilities they undertake to provide comprehensive and personalized care to patients, especially children with disabilities.

Care Plan Development

A care manager is a professional who creates customized care plans for patients based on their unique needs. These care plans take into account the specific medical, emotional, and lifestyle needs of the child, as well as the resources available to the family. The care manager works closely with the family of the patient, helping them understand the care plan and providing guidance on how to implement it effectively. They are also responsible for monitoring the child's progress and making necessary adjustments to the plan as needed.

Patient Education

Educating the patient, and the family, is a crucial responsibility of a care manager. They ensure that the family understands the child's condition, the treatment options available, and the steps they need to take to manage the child's health. This educational role extends to facilitating follow-ups with primary care providers and coordinating appropriate services. Care managers believe that building effective relationships with patients and their families significantly improves patient outcomes and satisfaction.

Medication Management

Medication management is another key responsibility of a care manager. This involves ensuring accurate medication reconciliation, monitoring the child's response to the medication, and addressing any side effects or complications that may arise. The care manager also provides education about the medication, explaining why it is needed, how it should be taken, and the potential side effects to watch out for.

Care managers play a vital role in coordinating care and working with a large group of people to ensure successful wellness programs. This includes reaching out to individuals on a monthly basis to review medical records, discuss care plans, and identify red flags to prevent health issues from escalating [4].

In conclusion, the skills and responsibilities of a care manager are diverse and multifaceted, reflecting the complexity of the care they provide. By developing individualized care plans, educating patients and their families, and managing medications, care managers significantly contribute to improving the quality of life of children with disabilities and their families.

Challenges Faced by Care Managers

Care managers play an essential role in the healthcare system, especially for families with children with disabilities. However, their work comes with its own set of challenges. Some of these include time management, administrative duties, and coordinating medical treatment. Understanding these challenges can provide a clearer picture of what a care manager does and the complexities of their role.

Time Management

One of the most significant challenges care managers face is time management. According to Patricia Russ, ThoroughCare’s Clinical Director, care managers might coordinate services among a large number of patients, sometimes up to 250 patients per month [3]. This includes reaching out to individuals on a monthly basis to review medical records, discuss care plans, and identify red flags to prevent health issues from escalating [4]. Juggling these responsibilities with other tasks requires effective time management skills and the ability to prioritize the most urgent cases.

Administrative Duties

Administrative duties are another challenge for care managers. These duties include patient calls, charting, and care plan development. Efficiently managing these tasks is vital, and care managers often rely on intuitive care management software to automate processes and minimize the administrative burden [4].

However, managing patient-related information presents its own obstacles, including inefficiencies in access to patient-related information and having to use multiple information systems. These obstacles are more frequently reported as major barriers by care managers than lack of computer training and support or inefficient use of case management software [5]. Furthermore, inefficient use of case management software by care managers is associated with a higher workload.

Coordinating Medical Treatment

Coordinating medical treatment and care for patients is a significant part of a care manager's role. However, it can also be challenging due to the complexity of medical cases, the need for constant communication between various healthcare providers, and the need to continuously update care plans based on the changing needs of the patients. The process involves a deep understanding of the patient's medical condition, an ability to work with different healthcare professionals, and a knack for problem-solving to ensure the best care is provided.

In conclusion, while care managers play a crucial role in assisting families with children with disabilities, they face numerous challenges. Understanding these challenges can be beneficial for families as they navigate the healthcare system, highlighting the importance of support for care managers in their essential work.

Enhancing Patient Care

Care managers play a pivotal role in enhancing patient care, especially for children with disabilities. They are responsible for building patient relationships, linking with support systems, and coordinating care providers. In New York, parents of children with disabilities can greatly benefit from understanding what a care manager does.

Building Patient Relationships

A crucial aspect of a care manager's responsibilities involves building relationships with patients. This requires a deep understanding of nursing and the ability to engage patients, especially the children with disabilities, in care plans and goal management. They serve as the main point of contact between the patient and practice, diligently managing extensive workloads to ensure the program’s success. A care manager's ability to establish a trusting relationship with the child and the parent can significantly improve the child's care outcomes.

Connecting with Support Systems

Care managers play an essential role in connecting patients with social and community support systems. This is particularly important for children with disabilities who require comprehensive support to manage their conditions effectively. Care managers dedicate a significant amount of their time coordinating medical treatment and care for patients. They reach out to individuals on a monthly basis to review medical records, discuss care plans, and identify red flags to prevent health issues from escalating. By linking patients with the right support systems, care managers can ensure the holistic well-being of the individuals they serve.

Coordinating Care Providers

Interacting and coordinating with care providers is another crucial part of a care manager's role. They build relationships with physicians and other care providers at the practices they work with. Care managers are integral in defining systems for managing practice interactions, such as determining patient insurance coverage for prescription delivery. By effectively coordinating with care providers, care managers can ensure seamless care delivery, minimizing any potential roadblocks or misunderstandings that could impact the patient's care experience.

In essence, care managers act as the linchpin in managing the intricate web of patient care. They build strong relationships with patients, connect them with the necessary support systems, and coordinate with various care providers to deliver comprehensive and effective care to children with disabilities.

Technology in Care Management

In the realm of care management, technology plays an increasingly important role. With the help of various health Information Technology (IT) applications and mobile healthcare apps, care managers can streamline their tasks, improve efficiency and ultimately enhance patient outcomes.

Health IT Applications

Care managers rely on a variety of health IT applications to assist in their role. These include electronic health record technologies, health information exchange, case management software, and claims and authorization systems. These technologies aid in recording, tracking, and managing patient health data, ensuring all information is updated, accessible, and secure.

However, the use of multiple health IT applications can present its own challenges. For instance, care managers often face issues related to duplicate documentation in multiple health IT applications [5]. Moreover, inefficient use of case management software is associated with higher workload, which can detract from the time spent on direct patient care.

Use of Healthcare Mobile Apps

In addition to health IT applications, the use of healthcare mobile apps is also becoming increasingly common in the field of care management. Apps such as Medisafe, Round Health, TrekIT, and Wellth offer features that can help with medication adherence, care coordination, and patient engagement [7].

These apps can serve as valuable tools for care managers, helping them to monitor patient progress, encourage consistent medication usage, and facilitate communication between patients, caregivers and healthcare providers. Additionally, they can aid in proactively identifying and assisting patients in accessing necessary healthcare resources such as local clinics, support groups, financial assistance programs, and community resources.

In conclusion, technology plays a crucial role in modern care management. By being advocates for patients and leveraging the capabilities of health IT applications and mobile apps, care managers can help improve patients' overall healthcare experience and outcomes.

Improving Patient Outcomes

Care managers are instrumental in improving patient outcomes. They are deeply involved in chronic care management programs, fostering patient engagement, and ensuring effective hospital discharge planning. All these activities significantly contribute to enhancing the quality of care for patients, particularly children with disabilities.

Chronic Care Management Programs

Chronic Care Management (CCM) programs are an important aspect of what a care manager does. These programs are designed to support patients with chronic conditions and ensure they receive the care they need. Care managers play a vital role in these programs by providing 20 minutes of non-face-to-face interaction per patient per month under CPT Code 99490. For patients who require more care, an additional 20 minutes beyond the initial 20 minutes can be provided, billable under CPT code 99439, which can be billed twice for patients requiring 60+ minutes of care.

These interactions encompass various activities, such as reviewing patient records, coordinating with other healthcare providers, and developing care plans. By performing these tasks, care managers help to enhance the continuity of care and improve patient outcomes.

Patient Engagement

Patient engagement is another crucial area in care management. Engaging patients in their own care fosters a sense of responsibility and enhances coordination of care, thereby helping patients effectively manage their health conditions.

Care managers use various strategies to boost patient engagement, such as providing clear and understandable information about the patient's condition, involving patients in decision-making processes, and encouraging them to ask questions about their care. In this way, care managers empower patients to take an active role in their healthcare, which can lead to better health outcomes.

Hospital Discharge Planning

The hospital discharge planning process is a key aspect of care management. An effective discharge planning process ensures that patients, especially those with disabilities, are safely and successfully transitioned from the hospital to their home.

Care managers coordinate with various healthcare professionals to develop a detailed discharge plan. This plan covers aspects such as medication management, follow-up appointments, and home care instructions. By overseeing this process, care managers help to reduce the risk of readmission and ensure that patients continue to receive the necessary care after leaving the hospital.

In conclusion, care managers play a significant role in improving patient outcomes. Through their involvement in chronic care management programs, patient engagement efforts, and hospital discharge planning, they help to enhance the quality of care and improve the health of patients with disabilities. With their expertise and dedication, care managers truly are the unsung heroes of healthcare.

References

[1]: https://resources.workable.com/care-manager-job-description

[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530792/

[3]: https://www.thoroughcare.net/blog/traits-skills-successful-care-manager

[4]: https://www.thoroughcare.net/blog/what-is-a-care-manager

[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557451/

[6]: https://www.chartspan.com/blog/what-is-a-care-manager/

[8]: https://www.linkedin.com/pulse/overcoming-challenges-care-management-relationships

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