Management experience is more important than a nursing license.

Successful case management leaders must create a culture of trust by pushing the envelope of communication and information sharing, unlocking the potential of the employees by fostering an entrepreneurial mind-set, decentralizing decision making, and transferring the ownership of "change" to the staff members. And you don't have to be a nurse to do it!

I don't get it!

I've been in the case management business for over 25 years and it didn't take me long to figure out that working with a team of hospital-based professionals required a leader with mature management skills, excellent communication skills, and knowledge of hospital operations.  And soon after that epiphany, I realized that the individual didn't have to be a registered nurse.

Today, when I see all the adverts for case management directors with a required nurse license, I have to ask, "Why?"

Hospital case management programs are often compilations of several service lines. I've encountered case management programs that include care coordination, medical records, access management, utilization review, social services,clinical documentation improvement, denial and appeal services, performance improvement and several others. Though I realize that the various ways hospitals organize services are highly dependent on size, I am often perplexed about the variety of services that are under the case management umbrella. However, I am not baffled about the type of leadership these varied services need to forge collaborative relationships, develop new ways to track each service line’s contribution to the organization, and build trust and influence attitudes.   

Generally, case management provides a vehicle to focus the attention of various specialists into a single program that collectively can achieve higher levels of performance and achieve Triple Aim outcomes: Improve patient's experience of care, reduce costs of care, and improve the quality of care.  So, in addition to more traditional management skills such as financial management and project management, case management directors must have polished political skills to develop and market a vision for the program. They must be able to provide enough clarity to enable people to envision something new and distinctive when compared to the status quo. They must be able to engage community resources, and build relationships. They must lead marketing efforts and increase the visibility and contributions of each service line. They must engage the medical staff and build goodwill among all members of the hospital leadership team to gain support for future growth. 

I once read that just as managers have subordinates and leaders have followers, managers create circles of power while leaders create circles of influence.  Case management program Directors must integrate the features of good managers and strong leaders. They must be able to work with different specialties to accomplish goals and at the same time they must have the ability to influence, motivate, and enable others to contribute toward operational success. These attributes are not 'owned' by a nurse.  So if you are recruiting a new program Director, consider this commentary as my expression of past experience, and find a candidate who can think beyond problems and inspire people to convert challenges into opportunities, one step at a time.