Scrambling for CM certification? Here’s what to know about 6 choices

CMcredentials connote competency: Research ‘alphabet soup’ carefully

It’s an unwritten, unspoken fact: Employers looking for case managers and customers looking for case management services want credentialed case managers.

Case managers who aren’t certified are busy filling out certification program applications and taking courses. Case managers who are certified are more marketable and command higher salaries. (For more information on salaries for credentialed and noncredentialed case managers, see the salary survey report in Case Management Advisor, November 1996, supplement.)

"Being certified makes you a much more marketable commodity. Insurance groups, case management firms, and health maintenance organizations are all looking for people with expertise in case management," notes Nancy Skinner, RN, A-CCC, CCM, a case management consultant with Ivonyx, an infusion therapy company based in Detroit. "If those potential employers see those coveted initials after your name, they recognize that you have proven a certain degree of competency in the field. That’s what has everyone scrambling for certification."

But accusations of examinations unfairly weighted to specific practice settings and rumors about high denial and low pass rates rumble through the case management community. In fact, nurse case managers raised so many questions about existing certification programs currently available to them that the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association in Washington, DC, is actively developing a case management credential specifically for nurses.

"The current certifications available for a case management specialty are multidisciplinary. We’re developing a test in response to the nursing community that is specific to the discipline of nursing," explains Carolyn K. Lewis, RN, PhD, director of the ANCC. "I’d like to say we’ll have a certification process in place by the end of 1997, but we don’t have a definitive time line, yet," she adds.

Finding the right certification program for you may come down to a simple process of researching the certifications available to case management professionals, taking an honest look at your own experience and practice setting, and finding the proper fit. "Case managers should look at the practice setting they work in and see what that setting wants in terms of credentials. Then they must really look closely at themselves, their experience and expertise, and find the best match. That’s the best way to avoid the problem of not meeting the eligibility criteria of a given certification program,"says Jeanne Boling, CRRN, CDMS, CCM, executive director of the Case Management Society of America in Little Rock, AR.

This issue of Case Management Advisor examines six certification programs available to case managers to help you make educated choices about the certifications best suited to your own professional development. (For easy comparisons and quick reference information, see pp. 3-4. For more information on how to judge the quality of a certification program, see story, p. 5.) These certification programs include:

• care manager certified (CMC);

• certified case manager (CCM);

• certified disability management specialist (CDMS);

• certified rehabilitation registered nurse (CRRN);

• continuity of care certification, advanced (A-CCC);

• certified professional in health care quality (CPHQ).

CMs should think through decisions

"Case managers have to think seriously about what kind of services they deliver, the type of organization or facility they work for, and the type of cases they are handling and match those factors against the eligibility criteria of the different certification programs," agrees Eda Holt, chief executive officer of both the CCM program managed by the Commission for Case Manager Certification and the CDMS program managed by the Certification of Disability Management Specialists Commission in Rolling Meadows, IL. "Most of the denials we have for the CCM are because applicants’ job descriptions don’t fit the eligibility criteria. I really think case managers should sit down with their employers or an immediate supervisor and make decisions about certification in conjunction with that employer based on real industry needs." (For Holt’s official response to commonly asked questions about the CCM, including denial rates and the appeals process, see the supplement inserted in this issue. See also, Case Management Advisor, July 1996, pp. 95-97.)

And, although denial rates for the CCM examination, or the number of applicants who are not allowed to sit for the examination because they fail to meet eligibility criteria, are high at 394 denials for the Spring 1996 examination cycle, the pass rate compares favorably to other certification programs at 80% for the Spring 1996 cycle. For example, the certification pass rate for first time candidates of the CPHQ in 1995 was 76%.

Search the field

The CCM has been so popular since the grandfathering, or field testing period, in 1993 that many case managers fail to consider other certification programs available to continuity of care and disability management professionals. "The A-CCC is an excellent credential for case managers working in acute care and subacute care practice settings. It focuses more on accident and health and has none of the workers’ comp issues which appear on the CCM exam," notes Skinner. "The confusion and frustration with the certification issue in the case management industry come from the fact that so many professionals are entering the case management industry who have a wide range of professional experience and education," she observes. "Occupational health nurses are becoming case managers. They have their own occupational health certification. Does the marketplace demand that they sit for the CCM, as well?"

The answer is "maybe," says Julia A. Rieve, RN, BSHCM, CCM, CPHQ, FNAHQ, president of Care and Quality, a case management consulting company in Oakland, CA. "Certification is still voluntary. Yet, if an organization has two applicants for a case management position, they will always chose someone with the credential most specifically related to the job requirements. The credential is not only the organization’s assurance that the applicant is competent, but hiring credentialed case managers decreases an organization’s liability, as well," she explains. "In California, employers are writing preferential want ads for case managers with certifications," she adds.

But again, case managers come from a variety of disciplines, and have a variety of professional tasks, stresses Rieve. "Case managers who do any type of quality improvement initiatives may want to consider the CPHQ exam," she says. "The practice of quality improvement has been around longer than the practice of case management. it is better defined and established. Those issues combine to make the CPHQ easier to study for than other exams available to case managers."

A newcomer to the case management certification field is the care manager certified (CMC) program which completed its first national examination cycle in July 1996. "The CCM is very medically oriented. Those on the social service side of the case/care management industry felt that we’d been under represented in this field," notes Rona Bartlestone, MSW, LCSW, BCD, CMC, president and chief executive officer of RNA Bartlestone Associates in Ft. Lauderdale, FL, and co-chair of the National Academy of Certified Care Managers (NACCM) in Hollywood, FL. "We put together a group to develop an exam which better represented a more psychosocial, more proactive approach to case/care management."

Rather than using a grandfathering, or field testing, process to validate the CMC examination, the NACCM hired PES, a professional examination services company, in New York City, to coach it through a complicated validation process, notes Bartlestone. "Each step in the process was validated using a highly tested, highly acceptable scientific process," she notes. "We’ve developed a practice-based exam that centers around the process of care management. We’re more interested in testing the skills necessary to apply knowledge than knowledge itself," Bartlestone adds.

"The case management industry has separated into splinter groups over the issue of certification," notes Rieve. "There’s a perception that there is this strong, desirable certification process out there, and not everyone can get into it. Others feel that they simply just don’t fit in the existing categories or eligibility criteria of the available certification programs," she notes. "But the truth is that there is more than one choice, and with a little research, case managers should be able to find a certification programs that fits their practice," adds Rieve.

[Editor’s note: New certification opportunities continue to emerge. When Case Management Advisor went to press, the American Board of Disability Analysts (ABDA) in Nashville, TN, expected to have its first certification exam ready in late January or early February. The examination is open to a wide range of professionals, including nurses, social workers, therapists, and health educators. For more information, contact: Certification Examination Committee, ABDA Central Office, 345 24th Ave. N, Suite 200, Nashville, TN 37203. Telephone: (615) 327-2984. Fax: (615)327-9235.]