Developing a plan that is agreeable to all parties requires skills in communication, negotiation, and collaboration. Case managers check with providers to be sure certain services are available. They check with payers to ensure services are covered and follow required guidelines for authorization. They also check with the family members who are expected to take an active role in providing care. Case managers use their knowledge of benefits, the healthcare system, the provider, and vendors to establish and implement a plan that is both comprehensive and practical, and to make recommendations based on solid cost-benefit analyses.
Case managers facilitate and initiate action when needed, functioning as agents of change.
They contact providers to discuss the plan and confirm providers' part in the plan. Often, a case manager's time is spent facilitating care, removing barriers to care, and ensuring access to services. He or she makes referrals and links patients to the appropriate programs, for example. A case manager may arrange transportation, coordinate scheduling of care providers, and deal with language and cultural barriers. Keeping patients involved allows them to prepare for changes and transitions in care.