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Successful application for case management certification can mean the difference between earning a valuable credential and throwing away a few hundred dollars. It’s essential to understand the application process and to understand your job description as part of that process.
For Kathryn Bennett, RN, BS, case management coordinator at Bloomington (IN) Hospital and Healthcare System, the road to certification was harder to navigate than she expected. Bennett chose to apply for the Certified Case Manager (CCM) credential from the Commission for Case Manager Certification (CCMC). "That’s the one to get." But the requirements for eligibility to sit for the exam are very stringent, she says.
Bennett says she found out, as other applicants have, that her job description did not quite meet the commission’s "continuum of care" requirement. "I work in a hospital setting and do refer across the continuum, but one of the requirements is that the continuum must address the ongoing needs of the individual rather than being restricted to services related to a single episode of care or treatment. At one time, our department was basically utilization review," and although the department’s case managers now provide care across the continuum, their job descriptions didn’t reflect that.
"If you’re in the hospital setting, you’re not going into the patient’s home and [you may not] see the patient’s whole life. However, we are . . . doing a lot of the things that case managers do," she adds.
Anne Llewellyn, RNC, BPSHSA, CCM, CRRN, CEAC, owner of Professional Resources in Management Education, a Miramar, FL-based consulting firm, says the solution to that obstacle is as easy as writing a letter. "It’s how you word everything," she says. "The application process is used to ensure that those who qualify for the exam have a good understanding of the process of case management. For some, navigating the application process can be as difficult as taking the exam.
"If your job description is vague, then you can write a day in the life’ and have your supervisor sign it," she advises.
In fact, the CCMC addresses the question of job descriptions on its newly revised Web site in a "frequently asked questions" section. It states, "If for some reason your job description inadequately describes your case management activities, you may write a letter describing what your job duties are in relation to the eligibility criteria. The letter must be on your employer’s company letterhead, signed by your supervisor, and notarized."1
Carrie Engen, RN, BSN, CCM, president of Advocare Inc. in Naperville, IL, and chair of the CCMC, says understanding the eligibility requirements is essential for anyone planning to sit for the exam. The option to write a letter has existed for several years, she says, "because sometimes job descriptions do not adequately describe the job duties, especially in the case of an employee of a corporation which, as experience has shown us, may have very global job descriptions."
What is more important than the corporate aspect is the CCMC’s mission to uphold certain standards. In the past, Engen says, many people who were in positions within health care wanted to call themselves case managers, "which . . . led to some problems with credibility for the entire industry and was one of the reasons that certification was put together in the first place. In [many] cases, hospital-based individuals were doing discharge planning, and once the patient goes home, there is no follow up at all. This is leaving out a very important part of the process — monitoring — integral to case management," she explains.
"Now if a hospital-based case manager is in actuality following up with the patient, monitoring that patient, reevaluating the plan of care, troubleshooting, etc., but it is not reflected in the job description, then within the certification guidebook, there is a remedy," Engen says. "We do not deny individuals applying from the hospital-based case management sector as a matter of course; however, just like everyone else, their job descriptions and/or supporting documentation have to reflect appropriate case management duties as stipulated in the guidebook as well as appropriate licensure and/or certification."
Llewellyn stresses that follow-up with discharged patients is something that hospital case managers must actively pursue, not just to meet certification or accreditation rules, but because it is good care. "I am hopeful that discharge planners do follow-up in some way on the plans that they set up, even if it is not mandatory. This is a professional responsibility. The goal is that the case manager is working with the patient to see that things go well, and if not, they have someone to follow up with so [the patient doesn’t] fall through the cracks."
Bennett agrees. "Some [hospital facilities] say they do case management discharge planning but actually just inform the insurance company that the patient needs home care, and that’s it." On the other hand, she contends that many hospitals do perform continuum care after discharge but aren’t recognized for it. "I think there’s a big group that really do a good job of discharge planning and getting involved with the family, and they’re being missed in this whole [certification] picture."
Bloomington Hospital’s administration is now reviewing the case management department’s revised job description, which reflects some of the changes in their job philosophy. "We have started doing follow-up phone calls and working with outside agencies on making continuum pathways," she explains.
Once the new job description is approved, Bennett plans to go ahead with her application for the CCM examination. "I’m going to try. I still think it’s very difficult for hospital case managers to prove they go across the continuum, but I think good case management needs to be recognized within the hospital setting."
[For more information, contact:
Kathryn Bennett, RN, BS, Case Management Coordinator, Bloomington (IN) Hospital and Healthcare System. Telephone: (812) 335-5450. E-mail: email@example.com.
Carrie Engen, RN, BSN, CCM, Owner and President, Advocare, Naperville, IL, and chair, Commission for Case Manager Certification, Rolling Meadows, IL. Telephone: (630) 355-0001. E-mail: firstname.lastname@example.org.
Anne Llewellyn, RNC, BPSHSA, CCM, CRRN, CEAC, Owner, Professional Resources in Management Education, Miramar, FL. E-mail: email@example.com.]
1. Commission for Case Manager Certification (CCMC) official Web site: www.ccmcertification.org/pages/12frame_set.html.