Four Things To Look For In Your Next Medical Case Managers
Medical case managers are the air traffic controllers of the workers’ comp industry.
They’re responsible for coordinating an injured worker’s medical care, guiding the injured worker to recovery, managing critical state-by-state compliance requirements and ensuring that each stakeholder is accurately informed of an injured worker’s medical status and estimated treatment trajectory. Coordinating care and communication with often more than a dozen stakeholders, medical case managers play a central role in the success of each case. This means it’s critical you find some good ones.
Here are four things to look for in your next medical case managers to make sure you end up in the very best hands.
1. Medical case managers who value technology innovation AND human-to-human care.
New technology allows us to significantly streamline workflows for faster turnaround times, tap into rich patient data for more customized care plans and accurate timelines and identify opportunities to drive down costs. You want to work with medical case managers who easily adapt to new technologies in the industry and who are passionate about identifying ways to save time and resources.
At the same time, it’s important that your medical case managers still prioritize human-to-human interaction—both with you and the people they work with on your behalf. In an increasingly digital world, we find many medical case managers opt for the latest technology platforms but at the expense of providing genuine, human care. You want to find a resource that values both.
2. Deep industry expertise.
Successfully managing an injured worker’s care hinges on established industry relationships, deep and nuanced state-by-state compliance knowledge, medical expertise and the ability to navigate the inevitable obstacles that arise. From cut fingers to catastrophic injuries, you want to work with a team that can confidently navigate the most straightforward and complex cases.
We believe expertise comes from both schooling and in-the-trenches experience. It’s important you work with a team who has a solid medical foundation and, in practice, has seen it all. To help gauge the team’s experience, here are a few questions to ask:
How many years of experience does the team have in the industry?
What degrees and certifications do they hold?
What are some of the most complex cases your team has handled?
What states do you have the most experience navigating?
3. Proactively staying on top of the latest regulations and trends.
With fines for missed deadlines and more than a dozen stakeholders reliant on the expertise and guidance of medical case managers, it’s critical you work with a team who knows to expect—and is anticipating—any new rules, regulations or industry shifts that are coming down the pipe.
To gauge how well medical case managers are doing this, check out their services and their blog. Do they offer generic services or are they updating their offerings to account for changing needs in the industry? (For example, a few years ago we launched a medication management service to help proactively address the growing opioid epidemic.) On the blog, are they pushing generic industry content or sharing insights on how to manage the latest regulatory changes and trends? In both cases, you’re looking for the latter.
4. Has a formal system for managing success.
Finally, you want to work with a medical case management team that has a formal system for managing success. In a multi-process, multi-stakeholder environment, it’s critical that your medical case management team knows how to help you identify objectives, share their recommended approach for reaching them and provide a framework for measuring success within that framework.
For example, here at Viscardi, we provide custom analytics on every injury we manage through our proprietary database. We track hundreds, sometimes thousands, of data points on each claim, allowing us to track the progress and success of each case specific to the industry, the injured worker and our outlined objectives.
Two final qualities you’ll want to look for are assertiveness and compassion.
It takes a strong, confident medical case manager to advocate on behalf of the injured worker and, at the same time, make sure your needs are being met. Compassion is equally important. While it’s critical that the medical case managers you bring on board are skilled medical professionals with expertise in all the necessary forms and state requirements needed to remain compliant, we also know injured workers recover faster when they’re in the hands of compassionate medical case managers they trust.
If you’re looking to partner with a new medical case management team that ticks all of the above boxes, we’d love to chat.