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Home > Who > Profiles in Nursing > Diane A., RN, Case Manager, pursuing BS in Healthcare Management

 

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Diane A.

Columbia, MD
RN, Case Manager, pursuing BS in Healthcare Management

As a Case Manager on a Medical-Surgical and Orthopedic unit, I am in charge of coordinating plans for patients' health care services upon hospital discharge. I also advocate for my patients with their health plans to ensure they have insurance coverage for the home health care, durable medical equipment, rehabilitation, and other care they will need upon discharge. I participate in collaborative practice rounds, and inform colleagues about changes in managed care so they plan only covered care and the patient can avoid financial problems. I also help insurers understand the patient's clinical course in the hospital to assure reimbursement for the care we provide. I became a Case Manager to advocate for optimal health care for my patients after hospital discharge. Today's patients are more acutely ill, yet hospitalized for shorter periods of time, so it is vitally important to set up comprehensive care for patients in collaboration with the patients' family, physicians, social workers, physical and occupational therapists, home health nurses, and professionals in other clinical disciplines. Helping patients in this way is a challenging patient advocacy role, and I gain a real sense of fulfillment from doing it.

 

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