Diversity of the Care Manager Role

Care management can take on a very narrow focus or a very broad focus to cover a lot of ground depending on the size of the practice, the patient population, and the goals for the practice. Care management in one practice may focus on a certain patient population such as patients with diabetes; whereas, in another practice, it can be very broad and include patients with a number different conditions and issues.

For example, in one practice, tasks may include educating patients, teaching insulin injection, and providing follow-up for blood sugar monitoring. In another practice, the care manager may assist patients with care transitions, medication reconciliation/management, and chronic disease management and education, and provide health behavior change coaching and self-management goal setting. Care management often includes taking the lead role in care coordination between multiple providers of care and services, both medical care and community-based care. In addition, the care manager may be part of or even lead the practice’s quality improvement team. Along with this diversity in roles and responsibilities comes diversity in the care manager role name. Names for this type of role include:

  • Care manager – this may have several prefixes to it such as complex, moderate, hybrid, or nurse (e.g., nurse care manager or complex care manager)
  • Case manager
  • Care coordinator or clinical care coordinator
  • Health navigator, nurse navigator, or patient navigator
  • Nurse educator, diabetes educator, patient educator, or health educator
  • Health coach

So how do you decide what to call your care manager? It depends on the circumstances including who you plan to hire for this role and what your patients and practice members might suggest as most fitting. There are no hard and fast rules. Here is what we have learned, however. Care manager and care coordinator are often very similar to one another. They often both deal with patients with chronic conditions. The difference is that the care coordinator usually focuses a bit more on care transitions and coordination of care activities; whereas, the care manager tends to focus more on chronic disease management. Case manager often refers to mental health and substance abuse or social service activities. Patients often take issue with the title of case manager.

The educator titles may focus a bit more on the education role, such as a diabetes educator who spends much of his or her time teaching patients how to eat properly and manage their insulin. Health educators are a specific profession that is quite different (see www.nches.org), so that title is not usually used or recommended. Patient educator is more appropriate. Navigators focus their activity more on helping the patient navigate or transition between health care settings. This has been very popular for cancer care for example. Last, care managers are not often called health coaches, as health coaches usually focus most of their attention on helping patients with making motivational health behavior changes such as quitting smoking or losing weight.
More important than what title you select for the role is that those interacting with the role know what it is and what it does and does not do.

By Complete Care Management, Inc.