Best Practice Case Management Roles and Functions: How to Optimize RN and Social Worker Skill Sets

Toni Cesta

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This webinar will focus on the Standards of Practice for social workers and nurse case managers as defined by the Case Management Society of America. It will also discuss best practices on how to optimize registered nurse and social worker skill sets in case management.

Why Should You Attend:

The role of the case manager and social worker is dynamic and constantly changing in response to the changes in health care delivery and reimbursement at the federal, state and local levels. While change remains a constant, there are certain core roles and functions that apply to the work of the social worker and nurse case manager regardless of job setting. In addition, case managers and social workers work within guidelines that provide us with definitions of practice, guiding principles and philosophy statements.

This webinar on roles and function will discuss the Standards of Practice for social workers and nurse case managers as defined by the Case Management Society of America as they were updated in 2016. The webinar will also discuss how to apply those Standards to the contemporary roles of the nurse case manager and social worker.

Finally, the presenter will show how to apply those roles to the ever day functions that social workers and nurses perform to complete their jobs. By understanding the fundamentals of the work we do, you will be able to apply this knowledge to your practice in any setting.

Areas Covered in the Webinar:

  • Introduction to the Standards of Practice
  • CMSA 2016 definition of case management
  • Statement of Philosophy
  • CMSA’s guiding principles for case management
  • Definition of a role
  • Role #1 Patient flow
    • Purpose and functions of patient flow
    • Goals of patient flow
  • Role #2 Utilization and resource management
    • Fundamental components of utilization management
    • Intersecting patient flow and utilization management
    • Resource management
  • Role #3 Denial management
    • Key functions of denial management
    • Shared roles
  • Role #4 Variance tracking
    • Functions within variance tracking
    • Goals of variance tracking
  • Role #5 Transitional and discharge planning
    • Discharge planning
  • Role #6 Quality Management
    • Quality management and the case manager
  • Role #7 Psychosocial assessment and counseling
    • Social work expertise
    • The social worker referral process
  • Integration of the roles
  • Summary of success

Who Will Benefit:

  • Directors of Case Management
  • Directors of Social Work
  • RN Case Managers
  • Social Workers
  • Directors of Quality Management
  • Vice Presidents of Nursing
  • Directors of Finance
  • Vice Presidents of Operations
Webinar Events
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Training CD-DVD

Physical CD-DVD of recorded session will be despatched after 72 hrs on completion of payment


Recorded video

Recorded video session



Speaker: Toni Cesta ,

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, new documentation systems, and other strategies for improving care and reducing cost. The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.


Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.


Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.


Dr. Cesta has been active in the research and development of case management for over 25 years. Her research in case management has included two funded studies measuring the effects of a case management model on congestive heart failure and fractured hip patient populations, with measures of patient satisfaction, quality of life, and short and long term clinical perceptions and outcomes.


Dr. Cesta has presented topics on case management at national and international conferences and workshops. Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”. Dr. Cesta is Consulting Editor of “Hospital Case Management Journal” and “Discharge Planning Advisor”. In addition, she serves as editorial advisory board member of several case management journals and publications including “Strategies for Healthcare Excellence” and “The Journal of Care Management”.


Dr. Cesta has a BS in Biology from Wagner College, a BS in Nursing from Adelphi University, an MA in Nursing Administration from New York University, and a Ph.D. in Nursing Research and Theory Development from New York University.


Dr. Cesta is a Fellow of the American Academy of Nursing. Among her awards are included the “Nursing Service Administration Award” from the New York State Nurses Association, the Jessie M. Scott Award for excellence in research, practice and education from the American Nurses Association, and three “Book of the Year” awards from the American Journal of Nursing. In 2010, she was awarded the Brooklyn Leaders Award from the Arthritis Foundation.


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