By building trust and partnerships during what is often a very challenging time, case managers are central to guiding injured patients back to health and meaningful work.
Accomplishing this in today’s work and health care environments requires case managers, and case management companies, to be better equipped and trained than ever before.
“There is almost an overwhelming range of workplace injuries and paths to wellness, so many employers today have a workforce that is spread across the entire country,” said Shannon Ford, Senior Vice President, Case Management Solutions for Paradigm. “To meet this reality, case management in workers’ compensation needs to be able to achieve a comprehensive range of services, while still staying highly focused on individual needs.” And when injuries become more challenging and complex, that’s when high-quality, people-focused, and expansive case management can be a real difference-maker in achieving positive outcomes.
Work-related injuries require case management solutions for a wide range of situations and circumstances, including coordination between multiple providers, patient history of previous injuries, multiple and complex injuries, and psychosocial or behavioral health concerns. “The higher the stakes of a case, the greater the need for resources and experience to address those challenges,” said Brenda Calia, Vice President, Case Management Delivery for Paradigm. “In the current environment, case managers must be equipped with the skills and resources to consistently achieve measurably improved outcomes for all types of cases, including the most complex and difficult injuries,” she said.
Added Ford, “A one-size-fits-all approach to case management does not work. Person-centric and outcome-focused results require case management solutions that provide expansive options and the highest commitment to quality.”
Achieving cost-effective results that return injured workers back to their families and communities means dedicated solutions for any need. “To meet the variety and complexity of claim and injury types, comprehensive case management should provide a diversity of solutions that can be custom-tailored for any eventuality,” explained Calia. Above all, it’s about having the ability to guide injured workers through the entire recovery and return-to-work process. “Clients need access to a bigger set of tools. In addition to traditional telephonic case management, some cases may benefit from field case management. In other situations, working with a nurse triage service can assess the required level of care right at the injury site,” she said.
“Achieving a positive outcome in workers’ compensation is about returning injured workers to productive activity,” stressed Ford. “Case management should be able to meet this key part of the journey through vocational services and transitional return-to-work programs.”
Another critical element is the ability to provide nationwide coverage. “Workforces are larger, and more spread out than ever before. Clients need to know that injured workers will receive quality case management and guidance, no matter where they are located,” explained Calia.
Of course, any set of options in case management must be able to achieve the objective it is designed to accomplish, which is why assuring quality is just as important. “Excellence in case management needs to come from an established track record for achieving unparalleled outcomes on a long-term basis,” said Calia. According to both leaders, quality needs to be measured by time, consistency, and human-centric collaboration in the following ways:
“Building long-term, consistent, and collaborative client relationships requires the relentless pursuit to understand, meet, and exceed expectations,” said Ford. “It’s ultimately about a deep commitment and understanding that everyone is there to truly improve the lives of the injured workers we mutually serve.”
Paradigm Case Management Solutions was built to deliver the range of essential services that modern cases need, combined with the unparalleled commitment to quality that has set Paradigm apart in catastrophic care management for decades. “We offer flexibility through a wide range of services that can fit nearly any need and deliver the level of quality that has distinguished Paradigm in the marketplace for more than 30 years,” explained Calia.
Paradigm’s case management options include:
Care is at the core of the Paradigm approach. Paradigm’s expansive options, along with nationwide coverage and unparalleled commitment to quality, help to ensure the best possible outcomes for everyone involved in the process.
Learn about Paradigm Case Management Solutions.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Paradigm. The editorial staff of Risk & Insurance had no role in its preparation.
Rather than searching for permutations of claims characteristics in swathes of data, you tell the machine to look for claim cohorts that are experiencing unexpected development – and set it off to do the searching.