Case Management
Accreditation
Case Management Accreditation
URAC's Case Management Accreditation sets the bar high for excellence in care coordination. Its robust standards and performance measures focus on key areas like improved patient engagement, enhanced service access and utilization, and smooth transitions of care. Notably, URAC recognizes the value of integrated care by incorporating behavioral health components into their case management standards.
Why is URAC Case Management Accreditation highly regarded? Health plans, payers, employers, and government agencies all view it as a vital catalyst for advancing collaborative care and patient advocacy. This accreditation holds particular significance for patients transitioning from inpatient care settings. Furthermore, it authenticates your Disability or Workers' Compensation case management process, ensuring accurate assessments of employee readiness for returning to work. This is valuable for both private and public employers.
By achieving URAC Case Management Accreditation, organizations demonstrate their commitment to delivering top-notch care coordination and gaining recognition from industry stakeholders.
How We Can Help
Integral Healthcare Solutions consultants have extensive experience with Case Management operations and accreditation requirements. Our Chief Clinical Officer, Sue DeMarino, RN, MSHS, CPHQ, RNC has experience as the Director of Case Management at Western Penn Hospital and performed approximately 500 Case Management Reviews while at URAC.
Whether your Case Management organization is already accredited or you’re at the starting gate of the process, we’ll walk you through the Gap Analysis, Mock Desktop Review, and Mock Validation Review, providing expert advice and tools like template policies, until you’re safely in the land of the accredited.
Case Management 7.0 Educational Videos
To help your Case Management organization get up to speed with the new 7.0 standards, Tom Goddard, JD, PhD, the CEO at IHS and Sue DeMarino, RN, MSHS, CPHQ, RNC, IHS Chief Clinical Officer, have created a series of short videos that discuss each of the CM-specific Focus Areas and highlight the major changes and standards that have been added or removed. We believe these summaries will be very helpful to you as you prepare for your reaccreditation.
The three videos cover three Case-Management-Unique focus areas:
Case Management Staff Qualifications, Training and Responsibilities (QTR)
Case Management Program (MM)
Workers’ Compensation Case Management Program (WM)
Case Management Staff Qualifications, Training and Responsibilities (QTR)
This conversation covers professional Case Manager credentials and competencies, and how to evaluate competencies; professional Case Manager orientation and training; supervision of professional case management staff including certification and other requirements of the supervisor; and roles and responsibilities and training of case management support staff.
Case Management Program (MM)
This section covers the case management program description; monitoring and evaluation; reporting and analysis of program performance metrics; screening and assessment process including medication review, assessment, and interventions; member case management plan development and ongoing monitoring; and case closure.
Workers’ Compensation Case Management Program (WM)
This section covers the case management program description; monitoring and evaluation; reporting and analysis of program performance metrics; screening and assessment process including medication review, assessment, and interventions; claimant/injured worker case management plan development and monitoring process; and case closure.