A Certified Care Manager (CM) is a professional who specializes in guiding an individual through the health care continuum for a given health situation.
A CM is a problem solver with specialized knowledge and skills in assessing, planning evaluating, coordinating and monitoring.
The goals of a CM are to identify and meet the individual’s medical care needs and preferences in the least restrictive, most appropriate and most cost effective setting.
In the acute care setting, the CM would identify the individual’s health issue and research medical practitioners who specialize in treating the identified health issue as to their training, rating and insurance acceptance.
This information would be presented to the individual to review, make a decision and schedule an appointment.
The CM would be available to accompany the client to the appointment to be a second pair of ears to listen to the doctor’s assessment/diagnosis/treatment plan.
In the long-term care setting, the CM would assist the individual in deciding where in the long-term care continuum to receive identified services: in the home or the community-a group home, an assisted living or a skilled nursing facility.
The CM would provide information on services provided, insurance coverage, cost and the Department of Health annual facility survey results to enable the individual to make a good decision.
In both the acute care and long term care setting, the CM would follow the individual and identify/treat medical problems to prevent a crises from arising.