About five years ago, managed care companies added case managers to their personnel structure to help stay abreast of innovative and complicated medical procedures that pioneering institutions, such as Johns Hopkins Comprehensive Transplant Center, are developing.
Case managers have nursing backgrounds and oversee medical treatment for insurance companies.
They have the authority to deny coverage for some procedures. This authority has the potential for creating adversarial relationships among hospitals, physicians and managed care companies. They toured the oncology and surgery departments and visited the childrens' and adult transplant units. They had the experience from intake to discharge. They want the best care for the patient within the fiscal constraints of the healthcare system.