|Reviewed by Kimberly Kelly-Cortez (Ph.D., M.S.Ed, MBA, CNE, NPD-BC), Senior Associate Dean and Director of Programs-Health, Leavitt School of Health.
The healthcare industry demands extensive planning and coordination in order for large groups of patients to receive quality treatment. Care and case management professionals each play an important role in this effort by mapping out treatment plans for patients effectively and creatively. While their jobs overlap, there are some important distinctions that make each unique. In general, care managers tend to focus more on the medical aspects of a patient's care, while case managers typically work with clients on a broader range of issues. This article will explore the major differences between care and case managers so that you can make an informed decision on which healthcare career to pursue.
What is a Care Manager?
Care managers work collaboratively with physicians, nurses, social workers, therapists, and other healthcare professionals to provide comprehensive care coordination. They may also serve as advocates for patients, helping them to navigate the healthcare system and access necessary services and resources.
The main goal of care management is to ensure that patients receive high-quality care and that their needs are met. Care managers assess patients' physical, psychological, and social needs, develop care plans, coordinate services and resources, monitor patient progress, and provide education and support to patients and their families.
What is a Case Manager?
A case manager coordinates the overall care of patients by following the protocols and policies of the healthcare provider. As most of their work is administrative, these healthcare professionals usually work in an office setting and process requests and approvals for various programs with treatment.
In healthcare settings, case management focuses on coordinating care and support services for patients with chronic conditions, such as diabetes or heart disease. They work with physicians, nurses, social workers, and other healthcare professionals to develop comprehensive care plans, coordinate with patients’ Medicare and insurance, and ensure that patients receive necessary medical treatment and social support.
In social services or insurance settings, case managers help clients access community resources like housing, food assistance, or legal aid. They also help clients navigate complex systems such as health insurance or legal processes.
Differences: Care Manager vs. Case Manager
While care managers and case managers have overlapping day-to-day responsibilities, there are some important differences in their work that make these careers unique. Here are some key distinctions between care managers and case managers:
- Focus: Care managers primarily focus on managing medical care and treatment, while case managers focus on coordinating services and resources for clients with complex needs.
- Setting: Care managers typically work in healthcare settings such as hospitals, clinics, or long-term care facilities, while case managers usually work in offices in fields such as healthcare, social services, and insurance.
- Client population: Care managers generally work with patients who have medical conditions, while case managers work with clients who have complex needs that may include medical, social, psychological, and legal issues.
- Role: Care managers focus on ensuring that patients receive high-quality care and that their needs are met, while case managers focus on advocating for clients, coordinating services and resources, and helping clients navigate the complex healthcare system.
- Education and training: Care managers typically have a background in nursing or other healthcare fields, while case managers usually come from social work, psychology, or other related fields.
- Responsibilities: Care managers are responsible for assessing patients' physical, psychological, and social needs, developing care plans, coordinating services and resources, monitoring patient progress, and providing education and support to patients and their families. Case managers are responsible for evaluating clients' care needs, coordinating services and resources, advocating for clients, and helping clients navigate complex systems.
It's important to note that the specific roles and responsibilities of care managers and case managers can vary depending on the setting and the organization.
Advance in Healthcare through WGU
If you’re ready to start a career in healthcare, whether you’re interested in a case management or care management program, start by checking out the relevant degrees at WGU. There are several reasons why WGU is a great place to earn your degree:
- We offer a competency-based education model, which allows you to move through your coursework at your own pace. The faster you demonstrate mastery of the material, the faster you can earn your degree.
- The tuition is much more affordable than traditional options. WGU’s low, flat-rate tuition is designed to create a cost-effective education, because we believe that the financial burden of college should not stop aspiring professionals from reaching their career goals.
- WGU is an accredited institution, which means our healthcare degree programs meet rigorous academic standards.
- Our flexible degree programs consist of courses that can be accessed at the convenience of the students. There are no in-person classes or strict deadlines, so you can finish your coursework when it works for your life and schedule.
WGU's healthcare degree programs provide affordability, flexibility, and academic rigor, making them an excellent choice for students who are seeking a future career as care givers in case or care management.