The Three Elements of Successful Collaborative Case Management
A great case manager is akin to an air traffic controller—meticulously coordinating the activities of numerous stakeholders. In the Workers’ Compensation industry, these stakeholders include the injured worker, the employer, the insurance company, medical professionals, CFOs, Risk Managers, TPAs, attorneys, administrators, and more.
Viscardi is renowned for some of the fastest and most efficient case management in the Northeast, consistently exceeding the national standard in returning injured workers to their jobs. With over 20 years of handling complex and catastrophic cases, we have discovered that effective collaboration is key to achieving the best outcomes for everyone involved. Here are three critical elements for successful collaborative medical case management:
1. Encourage Direct and Transparent Communication
The primary goal is to get the injured worker healthy and back to work, but each stakeholder has unique objectives. Employers aim to resolve claims quickly with minimal complications. Medical specialists prioritize providing the necessary care, regardless of time or cost. Insurance companies focus on keeping costs predictable and their clients satisfied. Medical case managers strive for rapid and efficient claims reporting to ensure timely treatment for injured workers.
To navigate these varying objectives, stakeholders must be direct and transparent with their questions, needs, and concerns. Nurse case managers collaborate with employers and carriers at the outset of each case to establish the best communication routes. Modern technology facilitates direct, transparent, and prompt responses.
The alternative? Prolonged cases, wasted resources, affected injured workers, and mounting frustration.
2. Humanize the Process
Over the past two decades, there has been a noticeable shift in the workers’ compensation industry towards efficiency at all costs. While efficiency is vital, the industry’s roots in personalized, human-to-human care must not be forgotten. Automated processes and “one size fits all” models have led to impersonal and detached stakeholder relations.
Efficiency should be a shared goal, but building relationships and relating to each other as human beings is equally crucial. The most effective way to inspire swift, focused action is to foster a shared belief and work with people who know and trust each other. Reflect on your work experience: aren't you more likely to prioritize a task for someone you trust and understand?
To cultivate human-to-human connections with stakeholders, we:
Prioritize face-to-face and phone meetings over email.
Continuously facilitate open conversations about what’s working and what’s not, and adjust accordingly.
Ensure everyone knows the roles, responsibilities, and anticipated involvement of each team member.
3. Stay Flexible
Each medical case management team is a unique system. Every stakeholder brings their own objectives, expectations, assumptions, and timelines, introducing nuances to best practice strategies. For one team, daily morning meetings might be effective; for another, fewer meetings and constant Group Chat communication might be better.
To achieve the objective of getting an injured worker safely back to work ASAP while meeting stakeholders' needs, flexibility is essential. A rigid approach can lead to frustration and delays.
At Viscardi, we stay nimble by holding weekly group meetings to monitor progress. Team members are encouraged to ask questions, voice concerns, and offer support to foster a collaborative environment. We also stay updated on industry news, attend events, and regularly check in with clients and stakeholders to innovate continually.
The Importance of Relationships
Successful, collaborative medical case management hinges on relationships. When we communicate openly, share expertise, offer empathy, and stay aligned in our objectives, we create an environment where everyone wins.