The importance of role clarity

A common problem that happens when new care managers are hired is that their roles and responsibilities are very ill-defined. Although flexibility and open-mindedness are generally good characteristics to have, lacking clarity often spells trouble for implementing a new role. A key problem is that other office staff members lack an understanding of this new role and therefore may try to fit the new person into a traditional role rather than understanding the new role. For example, office LPNs may feel threatened by an RN in the practice with the role of care manager if his/her role is to work separately with patients in independent visits to assist patients with chronic disease management. The LPNs may feel the RN is not “helping” by not rooming patients or answering triage calls, or they may feel threatened that she/he will take over essential tasks that are already theirs. Therefore, it is good to start with a basic understanding of the key goals to be accomplished by the overall work of care management and then divide out the responsibilities of different people on the team, including the care manager. Then have those roles and responsibilities spelled out in a written document that can be modified as needed over time and that is clear to everyone so they all know how their roles are alike or different and what the care manager role is contributing to the overall work in the practice.

Regardless of the specific job description, here are some key roles played by care managers:

  • Educator – impart knowledge about a health condition, how to manage a health condition, or how to use specific equipment or medications
  • Motivator – help patients identify and connect health improvement goals with actual plans
  • Accountability partner – provide follow-up and connection that is the extra nudge to keep progress moving, including monitoring progress and helping with setbacks
  • Liaison – work between the provider and other entities to identify and monitor needs and communicate to the needed groups
  • Cost container/resource re-deployer– Care managers often work with registries to identify patients who are at risk for expensive health conditions and try to prevent or reduce utilization; for example, patients who over-utilize the ER when calling the doctor would be more appropriate.
  • Social worker – identify family or social needs and connect with resources for assistance
  • Data manager – identify practice-level population health goals and track how the practice is doing in relation to those goals

The successful care manager will actively manage her or his role with activities such as planning and relationship building with the practice clinicians and staff, educating others on his/her role, meeting regularly to discuss progress and process, give and receive feedback. This work is very important to facilitating a team relationship that will conduct care management successfully.
Once the care manager role is generally well-defined it might help to have a short “elevator speech” to share with others as they have questions. This both helps get the team “all on the same page” with regard to what the care manager is and what s/he does, but also is critical to patient engagement. One consideration is for each team member to have a script for how each would use the care manager role.

By Complete Care Management, Inc.