Hospital Case Management 101: Case Managers Roles and Duties


Event Date: TBD
Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT
Duration of the training: 60 Minutes
Location: Online Webinar
By: Beverly Cunningham, MS, RN, ACM

As a new RN case manager or social work case manager begin their implementation of their role, it is best executed when both their role and the roles of other critical team members are understood. To be effective one must grasp both their role and that of their colleague for communication to be effective and for care of the patient to be transitioned throughout the hospital stay and on to the post-acute level of care location.

This webinar will focus on differentiating the roles of the RN case manager, the social work case manager, the appeals coordinator, the physician advisor, and optional roles that a case manager might have in place. Figuring out how to manage communication with payers – what is your role and what is their role – will also be discussed.

As case management staff interacts and collaborate, there are some strategies, such as walking rounds, patient care conferences and working with post-acute care providers, that will improve outcomes. Those outcomes not only will benefit the hospital, but with primarily benefit the patient and/ or family as they experience a hospital stay.

Lastly, this webinar will assist new case management staff in recognizing how they can impact case management department outcomes and the patient’s hospital stay.

Learning Objectives:
  • Understand the differentiation between the RN case manager and social work case manager roles
  • Apply the role of the RN case manager and/ or social work case manager in collaborating with key stakeholders in the patient’s care delivery
  • Discuss roles of colleagues who partner with case managers during the hospital stay
  • Describe outcomes that can be impacted by a hospital case manager – either RN case manager or social work case manager
Areas Covered in the Session:
  • Roles of the RN case manager and social work case manager: collaboration and working at the top of their licenses
  • Differentiation of the roles
  • Understanding department roles that complement the role of the case manager
  • Collaboration with key stakeholders outside the case management department
  • Effective roles during interdisciplinary meetings
  • Communication with payers: Their role and your role
  • Strategies for effective role development for new case managers
  • Expected outcomes when roles are efficient, effective, and successful
  • Live Q&A Session
Suggested Attendees:
  • Acute care RN case managers new to the role of ready for a refresher
  • Acute care utilization managers
  • Hospital case management leaders
  • Physician Advisors (especially those new in the role)
  • Acute care and long-term care RN case managers, critical access hospitals
  • CFOs or executives responsible for case management
  • Directors of Case Management
  • Director of Finance
  • RN Case Managers
  • Directors of Social Work
  • Directors of Compliance
  • Discharge Planners
  • Chief Medical Officers
  • Case Managers
  • Directors of Quality and Outcomes
  • Social Workers
  • Any Executive Responsible for Case Management
Presenter Biography:

Beverly Cunningham, MS, RN, ACM was most recently Vice President, Resource Management at a large acute care hospital. Her areas of responsibility included Case Management, Health Information Management, Patient Access, Solid Organ Transplant and Transplant Financial Services.

She has also been a Clinical Assistant Professor for the Master of Nursing Program at the University of Oklahoma, where she coached students in their clinical practicums. Bev is a well known speaker in the Case Management field. Involved in the development of case management for over twenty-five years, her areas of expertise include denials management, patient flow and the role of the Case Manager and Social Worker in the Case Management process. She has served as a Commissioner on the Commission for Case Management Certification and is a fellow with the Advisory Board. She has achieved ACM certification by the American Case Management Association. Bev’s publications include a chapter in CMSA’s third edition of Core Curriculum for Case Management Certification and most recently, co-author of the book, Core Skills for Hospital Case Management.

Bev has a BSN from Pittsburg State University, Pittsburg, Kansas and a Master of Science, Nursing Major, from the University of Oklahoma.