Premium Essay

Case Management

In: Other Topics

Submitted By siti101
Words 552
Pages 3
Case managers have a hard job. They are working with clients, dealing with a great amount of paper work, working with community agencies, and following rules and regulations. When managed care is a part of the equation it is much harder for the case manager due to what is and is not allowed. In this paper I will discuss managed care and how it affects the case manager’s job.
What is Managed Care?
Managed care consists of a variety of structures, processes and strategies designed to monitor, review, and guide processes of care (Mechanic, 1997). There are several types of managed care, the most popular being HMOs and PPOs. Managed care usually provides a network of providers that the client is allowed to see in order for the client to be covered. Managed care usually allows for the client to only obtain health care and services from those within their network. Here in lies the problem for case managers. Depending on the managed care that the client is under, he or she may not be able to utilize the resources that the case manager has provided for the client. It also may be more difficult for the case manager to find resources that are part of the allowed network within a client’s managed care plan. Managed Care in Case Management Managed care has an exceptional part in how mental illness is treated in our country. It can be very difficult for a case manager to find resources for a client with mental illness because the care they need may not be covered. To reduce costs, insurers tend to cut mental health benefits first. Because mental health varies so widely between clients, mental health costs are the most difficult to predict and are therefore very risky for managed care (Mental Health, 2008). Those with mental illnesses can require a great amount of services including medications, counselors, therapists, or even inpatient care. Their managed care...

Similar Documents

Premium Essay

Management Case

...Bradyn Stowe Management 321 Case 3 2/4/2016 Case 3: Everest Question 1: Why do people climb Mt. Everest? - People climb Mt. Everest for a myriad of reasons. Rooted in those reasons, though, you could probably find self-determination theory. They’re looking for autonomy, mastery, and relatedness. It struck me as kind of funny how in the case study so many of the climbers commented on not trusting or not believing in their team. Their team meant so much to them, climbing Mt. Everest with someone would be the highest form of bonding I could think of. As far as autonomy and mastery (competence), those are self-explanatory. Even though you’re with a group on the mountain, for a lot of it you are alone, there is a whole fight going on inside each of those climbers every day that they must do all on their own. People climb Mt. Everest to fulfill these intrinsic needs and drives. Question2: What types of mistakes in judgment and choices did climbers make? - It depends on if you consider dying on that mountain not worth it, really. Harris died, and I think he knew he was going to the whole time, but not getting to the top was just not an option, he’d rather die. And in that regard, he never made a mistake, it was all worth it for him. Anyone could say that the mistakes they made in judgment and choices were just over-confidence and they pushed it too far, but I just simply don’t agree. I’ve read the whole book written about this and I wholeheartedly believe everyone ended...

Words: 520 - Pages: 3

Free Essay

Management Case Study

...Management Case Study Angela Nichols XMGT/216 Organizational Ethics and Social Responsibility December 5, 2014 Debora Pryer Management Case Study Hello Debora, I received the instructions on cutting the payroll in my department by 15%. This is going to make a lot of unhappy employee’s, but I understand that it needs to be done. This will be a hard situation to come up with a solution, since we just hired several women and minorities to help with the diversity in the company. I have run across an ethical situation while deciding on how the best way would be to cut the payroll by 15% in my department. I feel that I need not to base my decision off of employee’s seniority with the company but the work performance of the employee’s. I know we need to keep a diverse work place. In order to do such a way that the diversity stays within the company I feel we need to evaluate each employee and base any decisions off of the evaluations. Just because an employee has been with us for an x number of years I feel does not mean they should be eliminated from the cutbacks. My best decision would be to evaluate each employee and based on the importance of their job for the company and their work performance whether or not to cut them back from full time to part time. If I am able to cutback almost half my department to part time hours I will be able to cut the payroll by 15%. Please let me know if you feel this would be a good way to cutback my payroll in the department. ...

Words: 281 - Pages: 2

Free Essay

Supply Management Case Study

...Running head: Supply Management Course Case Studies Case Studies Case Study #1 – Krause Corporation 1. Should Steve recommend buying the pipe or making it? Steve could go forward as planned and make the steel piping in house to save money by using the lowest cost lowest acceptable quality steel. This would be risky since the material would inferior and also the risk of toxic fumes being released due to bad welding etc. Buying the pipe already formed and of better quality would be the second option. In house machines did not provide the proper ability to make 20 foot sections of piping. This causes more seams to be welded and increases risk of toxicity. Labor cost would increase because of the extra welding and fabrication costs to include overhead costs. I would suggest Steve buying the piping. This would save on man hours to create and weld 8 foot pipes to needed length, ensure a better quality piping was procured, and show that priority was on safety with regard to hazardous materials being released through leaky seams etc. Although it appears that buying may be more costly, I wouldn’t suggest short cutting such a sensitive area. Case Study #2 – SMC Turbines 1. What options are available to Greg through basic supplier management? What actions do you recommend? Early supplier involvement is important in this case. Early matching of process and product is important. If the supplier can’t perform at......

Words: 902 - Pages: 4

Premium Essay

Cases of Management

...he combines a high‑energy approach to getting things done with aggressive marketing instincts. He’s just 36 now, but Jack can already boast a wealth of management experience, largely because he’s been quite adept at moving around in order to move up. He started out in sales for a technology company, outsold his colleagues by wide margins for two years, and was promoted to regional sales director. After a year, he began angling for a position as marketing manager, but when the job went to a senior sales director, Jack left for a job as a marketing manager with a company specializing in travel products. Though a little impatient with the tedious process of sifting through market‑research data, he devoted his considerable energy and creativity to planning new products. His very first pet project— a super‑lightweight compact folding chair—outstripped all sales projections and provided just the impetus he needed to ask for a promotion to vice president of marketing. When the company took too much time to make a decision, Jack moved on again, having found a suitable vice presidency at a consumer‑products firm. Here, his ability to spot promising items in the company’s new‑product pipeline— notably a combination oral‑hygiene and teeth‑whitening rinse for dogs—brought him to the attention of upper management. Jack expected to go to the top of the list of candidates for president of some division within the company, but instead the president of overseas......

Words: 7583 - Pages: 31

Free Essay

International Management Facebook Case Study

...Case Study: Facebook 1) In my country of origin, Morocco, Facebook is used primarily by people from 15 to 35 years old. The social network played a big part in the outburst of social revolts referred to as “Arab Spring”, since it was one of the only mediums for the people to keep their freedom of speech in times of tyranny. But it also has a couple drawbacks, in my opinion, the major one being the lack of control of users over their own personal data. This can represent a big inconvenience in some situations such as applying for a job. Nowadays, with employers making sure to search deeper and deeper into their recruits’ past and present social networking activities, any mistake a person might have made, even a long time ago, could come back and haunt him for the rest of his life. I think that the social network, by promoting freedom of speech and allowing people to keep in touch with their loved ones, even though in today’s globalized world it’s easier than ever to be far from them, is a great tool for the people of a developing country like Morocco. However in years to come, the emphasis should be on the challenge that is personal data encryption and protection, as well as user awareness on theses issues. 2) Faced with the need to define their approach to global expansion, Facebook chose to remain loyal to its values, in order to keep their international credibility as well as to justify their extraordinary IPO ambitions. The company is looking for market with a...

Words: 464 - Pages: 2

Premium Essay

Case Study 1 Surver of Hospitality Management

...Keller Graduate School of Management Case Study 1: Guest Satisfaction at the Convention Center Hotel Week 3 Irene Garcia Vilardosa HOSP582 Survey of Hospitality Management Dr. Pratt Introduction In order to be successful in the market it is not sufficient to attract new customers. Managers should also concentrate on retaining existing customers implementing effective policies of customer satisfaction and loyalty. In hotel industry, customer satisfaction is largely hooked upon quality of service. A management approach focused on customer satisfaction can improve customer loyalty, thus increasing the positive image of the touristic destination. Hence, exploring the importance for customers of hotel attributes in hotel selection is indispensable. Problems with front office In order to solve the customers dissatisfaction issues related with check in and check out, Frank should take into account the reservations and have more employees working at front desk when the number of reservations is higher so they do not have to be waiting for a long time. During major arrivals and departures days, the staff has to be increased so that the guests are quickly addressed and they can continue with their trips or business without wasting too long. Problems with housekeeping When dealing with a situation as described in which rooms are not ready, there are usually two possible options to consider. Either the housekeeping staff is not enough considering the number......

Words: 598 - Pages: 3

Premium Essay

Case Study- International Management

...Intercultural Management – Case study 1. Brief summary of the case The text describes the business activities and the development of a seven-headed Taiwanese family named Teng. Their field of activity includes a drygoods store from the very early beginning and later on the family business was accredited as official dealer of products of a Swedish motor manuacturer (Swedsa) in Taiwan who brought richness and success for the Tang family. In general the educational levels between the family members are completely different but everyone tries one’s best. After a business study one son proposed to reorganize the family business in order to progress the bad financial situation by giving fixed areas of responsibility to each member who did not bring the expected success. // The case talks about a family business in Taiwan having problems to adapt to changing conditions concerning business thinking, globalization and modern strategies. They aren’t competitive anymore. On the one hand they form a corporate business with a Swedish company on the other hand they miss to open up their strict traditional views so in the end they have to face that profits stagnate. 2. Problem statement The problem in this case is the difficult compatibility of business and family in one company. // Family vs. business ( Family is more important than the success of business The organigram of the company structure underlines this statement because all leading positions are equally divided......

Words: 1995 - Pages: 8

Premium Essay

Management Group Case Study

...During the summer, the company needs to hire around forty new employees which are typically college students from a local private college. They receive little training prior to starting working. All they are taught is the basics of how to do their job, not how to handle difficulties that arise. More and more employees start to get injured, and the president of the company decides the company needs safety training. The first-line supervisor gave a brief training that wasn’t very beneficial to the employees. Step 1: Identify the Problem The problem in this case is that Houghton Refrigeration Company is having complications maintaining a safe and healthy work environment for their employees, and now some of their workers are becoming injured. Step 2: Identify Causes of the Problem There are several reasons this problem could be occurring. One reason is that the upper management are educated in engineering, not management, which is the cause of the second reason for this problem. The second reason the employees are being injured is because they lack proper training. The college students are also feeling pressured by one of the first- line supervisors who is harassing them. Step 3: Alternative Solutions * The company can hire an outside source to develop a training program for the employees. * They can hold one-on-one training with each of the new employees and supervisors. * They can hire a safety representative for the company. Step 4: Select the Best......

Words: 419 - Pages: 2

Premium Essay

Management Cases

...Chapter 5 Activity-Based Costing and Customer Profitability Analysis Cases |5-1 |Blue Ridge Manufacturing (Activity-Based Costing for Marketing Channels) | |5-2 |Columbo Soft-Serve Frozen Yogurt: Using Activity Based Costing To Assess Channel/Customer Profitability | |5-3 |Wilson Electronics (A) | |5-4 |Wilson Electronics (B) | |5-5 |The Buckeye National Bank (ABC Costing in the Service Sector) | |5-6 |Precision Paint | |5-7 |Forest Hill Paper Company | | | | Readings 5-1: “Activity-Based Costing and Predatory Pricing: The Case of the Petroleum Retail Industry” by Thomas L Burton and John B MacArthur, Management Accounting Quarterly, (Spring 2003). The assignment of indirect costs in a volume-based costing system can lead to product-cost subsidization—overcost high-volume products and undercost......

Words: 33150 - Pages: 133

Premium Essay

Case Management

...Reta Sharfina Tahar 1111002006 Case 4-4 Whiz Calculator Company Questions: 1. From the information given in Exhibits 1 and 3, determine insofar as you can whether each item of expense is (a) variable with sales volume, (b) partly variable with sales volume, (c) variable with some other factors, or (d) not related to output volume at all. 2. What bearing do your conclusions in question 1 have on the type of budgeting system that is most appropriate? 3. Should the proposed sales expense budgeting system be adopted? Why or why not? 4. What other suggestions do you have regarding the sales expense reporting system for Whiz Calculator? Answers: 1) In Exhibit 1, the figures of selling expenses are fixed or appropriation basis wherein the managers use judgement method for arriving at the budget for succeeding year. This is known as static budgeting. They work well for evaluating performance when the planned level of activity is the same as the actual level of activity, or when the budget report is prepared for fixed costs. Thus, in old system, expenses are not related to output variable at all. On the other hand, in exhibit 3, the figures for budget are arrived at by using flexible budgeting system. It provides budgeted data for different levels of activity. For instance, travel expenses are partly fixed and partly variable with percentage of sales. The fixed component is based on the target of 65% capacity utilization wherein it is projected that minimum this would......

Words: 1609 - Pages: 7

Free Essay

Case Management Overview

...Case Management Overview Diana G. Resendiz BSHS/ 405 September 21, 2015 James Reeves Case Management Overview Case managers play an essential role in the helping process. Case managers take into account the person as a whole and focus not just on one problem, but also all the other variables (Summers, 2011). The case manager ensures the client receives the most individualized and effective treatments and plan for service possible. The many roles and responsibilities are carried professionally and ethically. The case manager also can use theoretical models to identify problem and cause of the client's behavior. Many times, case managers work with specific special populations and encounter issues that must be prepared to address. Roles and Responsibilities Case management primary purpose is to improve the quality of life the client by assessing their total situation (Summers, 2011). It is imperative that the case manager knows what their client wants not only for service but to have a productive and useful life. Case managers develop a comprehensive picture of each client and identify the specific intervention the client may need. Case management entails being respectful to the client, their family, and the diversity of the human experience. It also requires listening carefully and encouraging people to hope and work towards a productive and healthy life. Case managers utilize funding sources to support standard formal services, in some cases, medication, as well as......

Words: 1135 - Pages: 5

Premium Essay

Bucknell Management Case

...Art : first shift – hands on leader, very involved, almost a micro manager? He reminds people of procedures. People think he doesn’t get it. He needs to motivate his people in some ways. For example, he can use rewards or goal boards to highlight employees who followed correct procedure or who had no mistakes on that day. He can also create teams and have weekly contests where prizes could be lunch or some monetary value. This should help improve morale in a monotonous setting. Art should also take a cue from Tom and start learning some facts about his workers and celebrate birthdays, etc. He still needs to maintain the discipline on the floor, but work on being more personable. He can also borrow from Carol and include trouble shooting and build up sessions for his people. Bateman & Snell (2011)l would call Art a task-motivated leader Tom: 2nd shift. Very personable, people oriented supervisor. People like him and I think have taken advantage of his personality. This sounds like the toughest shift based on job responsibility. Tom needs to be more like Art by being involved in the day to day operations of this shift. Once he understands the challenges his people face, then he needs to provide training to everybody to ensure that they all understand how to do their jobs. He also needs to figure out which employees have mastered the different setups and make them team leads or the go-to people so whenever an issue arises, then they can handle it. He must also enforce the......

Words: 516 - Pages: 3

Premium Essay

Nurses in Case Management

...Case management nurses are registered nurses who coordinate all aspects of the care of different patients. Case managers deliver assistance within, between, and outside of facilities. Case managers need to be knowledgeable, well organized, and creative. The article reviewed exhibited a study carried out with community nurses to help cultivate case management within their scope of practice. The nurses involved in the study suggested for further entrenching case management as a means of helping patients with complex care necessities in their place of residence. The elements that can affect the community nurse’s capability to implement case management are demonstrated in the outcomes of the study. One of the elements mentioned include accessibility of resources (Smith, MacKay, and McCulloch, 2013). And as case managers we are experts at attaining resources but sometimes it is difficult finding some of these resources. I encounter this as a case manager every so often the state may not have sufficient funds and there is a long waiting list too. The option left is getting the support of a family member or the community where the patient reside or even the church. Another point mentioned is case managers getting family and the individual patient involved in care. “They considered it important that patients and caregivers are informed about the goals of care and are supported to take control over aspects of that care” (Smith et al., 2013). Case management nurses work with......

Words: 401 - Pages: 2

Premium Essay

Management Case Studies

...City doesn't want to pay $8.24 per passenger. • Controlling - Monitoring, checking budgets, etc. Mr Bourk's biggest job is setting the strategy and mission of the airport. 2. Again, using the four functions as your guide, do you think the managerial challenges Jeff Bourk faced when getting the airport up and running are different from what he faces now in actually overseeing the airport’s operation? Explain. Jeff Bourk will have to face pretty much the same challenges as before: organizing employees to build the airport, running the day to day operations like scheduling employees, maintaining security, dealing with HR issues. Leading will become more important as motivation of airport employees needs to be sustained. 3. What management roles would Jeff Bourk be playing as he (a) negotiates new contracts with potential airlines, (b) works with the airport employees in providing a high level of customer service to arriving and departing passengers, and (c) resolves the contractual issues with the city of Branson? Be specific and explain your choices. a. negotiate new contracts with potential airlines Decisional role b. works with the airport employees in providing a high level of customer service to arriving and departing passengers. Interpersonal role c. resolves the contractual issues with the city of Branson Decisional role 4. What skills would be most important to a manager like Jeff Bourk? Explain your choices. Human relations skills...

Words: 912 - Pages: 4

Free Essay

Online Bus Management Use Case Specification: Book Ticket

...Online Bus Management Use Case Specification: Book Ticket Version 1.0 Revision History |Date |Version |Description |Author | |14/feb/11 |1.0 |Usecase specification for booking ticket. |Samanth | | | | |Nagarjuna | | | | |Harish | | | | | | | | | | | | | | | | Table of Contents 1. Use Case Name 1 1.1 Brief Description 1 2. Flow of Events 1 2.1 Basic Flow 1 3. Special Requirements 1 3.1 Performance 1 4. Preconditions 1 4.1 Day restriction 1 5. Post Conditions 1 5.1 Print 1 Use Case Specification: Book Ticket Use Case......

Words: 260 - Pages: 2