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With the recent explosion in the number of credentials available to case managers, it’s become more likely than ever that you’ll find at least one that fits your needs, abilities, and aspirations. But deciding which one to pursue — or even whether the pursuit is worth your valuable time and effort — can be a confusing, even frustrating, undertaking.
What’s certain is that the field is moving resolutely toward a greater emphasis on credentialing, spurred on in part by emerging trends in case management and by government regulations.
Besides those trends, case management certification provides a real leadership opportunity and increases customer confidence, says Diane Huber, PhD, RN, FAAN, CNAA, associate professor at the University of Iowa College of Nursing in Iowa City. "Certification validates that certified practitioners are well-prepared for their jobs and promotes excellence in practice. This competency assessment provides the consumer with a basis for trust and confidence in a quality service," she says.
Trust is one of the most important aspects of the role of the case manager as a patient care planner. "Case managers . . . interact among providers on behalf of clients," at a time when any effort at health care cost containment is seen as suspect by most consumers, Huber says. "Without case management, clients face a costly, disconnected, and confusing health care delivery system."
In addition, she says, case management certification increases the practitioner’s opportunity to advance his or her career. "It supports the practitioner with a competitive advantage in the job marketplace." Huber should know: She is one of the recently elected members of the Commission for Case Manager Certification (CCMC) and a leader in the case management field.
The CCMC in Rolling Meadows, IL, offers three reasons case managers should consider getting a certification:
• An increasing number of employers are requesting certified case managers.
• Case manager certification is regularly specified in career advertisements.
• States are beginning to require certification for case managers — a trend that will continue.
Unlike other specialties — nurse midwifery, nurse anesthetist, or advanced practice nurse, for example — certification in case management is not mandatory in the United States. However, the CCMC estimates that more than 22,000 case managers have been awarded its certified case manager (CCM) credential in the past seven years, and many others hold other case management or quality-related credentials. Huber predicts that the number of voluntarily certified professionals will continue to grow, considering their need to distinguish themselves in the multidisciplinary field.
"Complexity and variability are part of the case management picture. Case management is multidisciplinary, and the CCMC was built on that very multidisciplinary foundation." In turn, the CCM credential was developed with a very broad focus, she says. Certification examinations that are specific to the various disciplines involved also have been developed in recent years. Most experts agree that if you choose to be certified, you should pick the credential that best fits your current job or your career aspirations.
The Healthcare Quality Certification Board, which administers the certified professional in healthcare quality (CPHQ) exam, has released a position statement on the issue of relevance to the employment setting. It states, "When considering how applicable a particular certification is to an individual employment position, we find some credentials are more specific to the individual components of quality, case/care/disease, utilization, or risk management, all of which are included in the CPHQ exam. Individuals who are currently satisfied with their employment performing in one
of these specific areas may find other credentials with less content breadth more applicable to their needs."
Anne Llewellyn, RNC, BPSHSA, CCM, CRRN, CEAC, says health care professionals should look for an appropriate certification. "The important thing to remember is that the certification measures expertise," whatever that certification may be. "There is case manager certification from the American Nurses Association (ANA)," she says. "If a nurse is in the hospital and plans to stay there, she may want to take [that] exam . . . since its focus is more clinical [than other exams]. I tell people looking for certification to see where they want to go and to look for the certification that will aid them in their career," she says.
Whatever your specialty, there are steps you should take in choosing the credential that will best serve you as a professional. Hussein Tahan, MS, DNSc(C), RN, CNA, director of nursing in cardiac specialties at Columbia Presbyterian Medical Center in New York City, says the one you pick is certainly dependent on your area of practice and the requirements of the certifying body. To make the best choice, he says, case managers should answer the following questions before choosing a particular type of case management certification:
1. What is the benefit of the certification for your career advancement and professional development? Will you be awarded a better salary, or will you be eligible for your dream job if you get the certification? Could you be promoted within your organization or reach some level of leadership?
2. Is the certification a prerequisite for your current or potential job/position options?
3. Is the certification a mandatory expectation for credentialing your organization? To date, the major accrediting organizations — The Joint Commission for Accreditation of Healthcare Organizations, The American Accreditation Healthcare Commission, and the National Committee for Quality Assurance — do not require mandatory case management certification of individuals when they survey organizations as a whole, Tahan stresses.
"However, they look into evidence of qualified professionals taking care of patients. That means that [professionals] have the appropriate training, education, and competencies, and certification is a measure of those competencies. It could help show the accrediting body. We have this percentage of certified case managers,’ which, yes, will help [the organization] meet the competency criteria," he says.
4. Which care setting do you practice in (acute vs. insurance/managed care or community care), and what are the specific standards of care, practice, and performance present in your practice environment? "For example," Tahan says, "are they managed care-related, rehabilitation- and disability-related, health care quality- and outcomes-related, or occupational health-related?" That can have specific impact on which certification you choose to pursue.
5. What are the eligibility criteria of each of the available case management certifying exams, and for which are you able to meet the criteria? Sometimes the case manager’s job description does not necessarily describe the duties of case management required by a certifying organization’s criteria. It is important that your day-to-day activities are considered in line with the national practice for the exam you want.
6. What is the cost of each of the exams, and who will pay for your certification — you or your organization? "Many employers are requiring the CCM or another certification, [such as] the ANA’s certification. When they require it, they might pay for it also," says Llewellyn. She encourages case managers to approach their employers about paying for the exam. "Let them know that this is a way to improve the department’s clinical competency. Certified individuals have to stay abreast of information since they are required to have a certain number of [continuing education units]. This keeps them on top of things. Also, it gives the case manager credibility," so it might be a valid expense for the organization.
7. How long is the certification valid? Recertification may require taking another exam, paying an annual fee, completing a certain number of continuing education credits, or a combination of any of those requirements.
8. How much information/what kind of information is available from the certifying bodies? Some organizations offer sample questions for test preparation; others might offer a full seminar or course. With either of those options, it is important to remember that case management is a practice-based specialty. No matter how much you study, the best way to be prepared for the certification exam is to be engaged in the practice of case management in some form. "Practice provides an opportunity to experience situations that tend to be unusual. You wouldn’t read about them in books because books and texts tend to be theoretical," Tahan says.
"Also, books tend not to be current; sometimes it takes a year before they make it to print. As quickly as the nuances and new changes happen, the text may not catch them, while the practice setting has to implement those changes right away. And that better prepares you to answer questions on the test," he explains.
It’s important to realize that the information available about the test could be an indicator of its agency’s credibility. The more influential the agency is, the more information it will probably share about its exam, Tahan says.
"You can compare the available information with your practice, knowledge, and skills and ask, Does this exam fit my career options right now? I don’t want to sit for an exam that’s heavily insurance when my practice is acute care.’" The bottom line: The exam you choose should match your career advancement potential, he adds.
"The health care environment continues to experience rapid and tumultuous changes," he continues. "These changes make verification of the competence of case managers an increasingly important issue."
While certification certainly does not guarantee that a case manager is competent, it demonstrates that a minimum national standard has been met and the case manager intends to show his or her competence by maintaining those standards in practice, Tahan points out.
[For more information, contact:
Diane Huber, PhD, RN, FAAN, CNAA, Associate Professor, College of Nursing, The University of Iowa, Iowa City. Telephone: (319) 335-7122.
Anne Llewellyn, RNC, BPSHSA, CCM, CRRN, CEAC, Owner, Professional Resources in Management Education, Miramar, FL. E-mail: firstname.lastname@example.org.
Hussein A. Tahan, MS, DNSc(C), RN, CNA, Director of Nursing, Cardiac Specialties, Columbia Presbyterian Medical Center, New York City. Telephone: (212) 305-3888. E-mail: email@example.com.]