Responsibilities of the nonlicensed case manager extender

The nonlicensed case manager extender is able to assist the patient and follow the patient’s individualized plan of care with the guidance of the professional case manager. The nonlicensed case manager extender can accomplish this through the following activities:

• Obtaining medications
• Using pharmacy voucher programs
• Assisting patients with the application process for the pharmaceutical voucher programs
• Precertifying medications
• Procuring a primary care physician (PCP) for patients without a PCP
• Arranging transportation home from the hospital or to and from appointments
• Scheduling follow-up appointments
• Researching resources across the continuum, such as food banks, job resources, Meals on Wheels, senior services, and clothing and furniture depositories
• Providing education and tips on navigating the healthcare system

The nonlicensed case manager extender allows the professional case manager to work at the top of his or her license. The assistant is the daily "boots on the ground" often needed by patients to help them stay on track. The assistant may provide the daily coaching patients need and encourage them to work hard to maintain their health and wellness.

The nonlicensed case manager extender and the professional case manager teach the patients to fish. The nonlicensed case manager extender doesn’t just perform the task for the patient; he or she shows the patient how to do the task. For example, if the nonlicensed case manager extender is completing a pharmaceutical voucher program application, he or she tells the patient what steps must be taken to complete the form. The nonlicensed case manager extender may even ask the patient to complete the form as he or she guides the process. The patient will then be able to complete the form independently the next time it is needed. The assistant may be close to the patient and can uncover barriers to healthcare as they walk the walk with patients. These barriers include:

• A lack of community providers accepting Medicaid and Medicaid HMO products
• A lack of transportation resources
• A lack of medical and surgical specialist availability
• The cost of medications
• The need to precertify prescribed medications

Many patients who present to the emergency department (ED) do not have a PCP because they are not insured, committed to an assigned physician who is not close to their home, or are ostracized through drug and alcohol abuse. The team of the professional case manager and nonlicensed case manager extender working in or with the ED provides a link for these patients to connect them to the appropriate healthcare system or service.

For more information, see Case Management Guide to Population Health: Management Across the Continuum of Care.