Certification among case managers on the upswing

CMAC adds two avenues to eligibility

The Credentialing Advisory Board (CAB) for the Case Management Administrators Certification (CMAC) recently announced two new avenues to CMAC examination eligibility. That marks the latest step in a trend toward increased certification among case managers that many say can pay significant dividends for case managers and case management programs alike.

The two new routes to certification rolled out by CMAC, which is sponsored by The Center for Case Management in South Natick, MA, are designed specifically to certify case managers as administrators:

  • CSWCM (Certified Social Work Case Manager) and CASWCM (Certified Advanced Social Work Case Manager) from the National Association of Social Workers in Washington, DC;
  • RN, C (Modular Certification in Nursing Case Management) from the American Nurses Credentialing Center, also in Washington, DC.

"This is a unique certification designed for professionals who administer case management programs," says Maureen McKenna, RN, LSW, director of care management at Lifespan/ Physicians PSO in Providence, RI. She says the exam is designed to determine how current administrators are in health care trends and case management. It also assesses how well they interpret data and their ability to use those data to demonstrate the impact of their programs, especially patient outcomes, she adds.

The majority of case managers are nurses, notes Shawna Cates, ACSW, LSW, CMAC, MBA, associate consultant at The Center for Case Management.

"As a social worker, the administrator credential is a key step for identifying the leadership role that social workers can assume," she asserts. It also underscores that social work is a viable profession to become a case management leader or administrator, Cates adds.

The majority of case managers are not currently certified, but a number of organizations now offer certification for basic knowledge for people who practice case management, and the trend is growing. "Certification is often the next career step for many case management professionals," says Karen Zander, principal and co-owner of The Center for Case Management.

She says the professional certification program, established in 1998, which focuses on the principles of leadership and management, continues to gain broad appeal.

That process comes with its own set of challenges, however. "The definition for case management is so varied from organization to organization that you would even have a tough time figuring out a denominator," says McKenna. "Some programs may be called utilization review but, in fact, are case management." Care management and care coordination are other terms sometimes used, she adds.

"If you look at the services they actually provide, they are providing case management in many instances," McKenna contends. She says consumers must be able to ask questions about what services are being provided, and national certification facilitates that by giving them a benchmark.

The importance of certification for case managers also is being recognized by payers. "The fact that this now ties into payers is very important," Cates says. "That leverages the role of the case management administrator and opens the eyes of hospital executives who don’t always know what the role and function of case management should be."

According to Guy D’Andrea, senior vice president of the Utilization Review Accreditation Commission (URAC) in Washington, DC, that organization now routinely certifies case management programs for hospitals and insurance companies. For example, he says, Blue Cross plans have been requested by the federal employee programs they cover that all the programs be certified by URAC for case management.

While URAC’s program certification for case management has been in place for two years, D’Andrea reports that based on the number of companies that have applied so far this year, there has been a real surge in interest among payers.

[For more information about credentialing, contact:

National Association of Social Workers, Washington, DC. Telephone: (800) 638-8799. Web site: www.naswdc.org.

American Nurses Credentialing Center, Washington, DC. Telephone: (800) 284-2378. Web site: ana.org/ancc.]