CCMC Glossary of Terms for Case Management

This set of flashcards contains key terms and definitions from the glossary of terms relevant to the practice of case management, aimed at helping students prepare for their certification exam.

ACCESS TO CARE

The ability and ease of clients to obtain healthcare when they need it.

ACCOUNTABLE CARE ORGANIZATION (ACO)

A set of healthcare providers that collectively accept accountability for the cost and quality of care delivered to a population.

ACCREDITATION

A standardized program for evaluating healthcare organizations to ensure a specified level of quality.

ACTIVE LISTENING

A communication technique involving focused attention on the speaker to facilitate cooperation and collaboration.

ACUTE CARE

Care delivery that focuses on treating sudden and serious episodes of illness.

ADHERENCE

The extent to which a person’s behavior aligns with agreed recommendations from a healthcare provider.

ADL (Activities of Daily Living)

Routine activities that individuals perform for self-care and daily living.

ADVOCACY

The act of recommending or pleading the cause of another person.

BENEFICIARY

An individual eligible for benefits under a particular health plan.

COMORBIDITY

The presence of one or more additional conditions co-occurring with a primary condition.

CONDITIONAL REHABILITATION PROFESSIONAL

A rehabilitation professional not yet qualified to meet all requirements for a qualified rehabilitation professional.

EVIDENCE-BASED PRACTICE

Healthcare practices based on the best available evidence from clinical expertise and research.

LONG-TERM DISABILITY INCOME INSURANCE

Insurance that provides periodic payments to replace income when an individual is unable to work due to disability.

OUTCOME INDICATORS

Measures used to assess the quality and effectiveness of care delivered.

REGISTERED NURSE CASE MANAGER

A registered nurse responsible for coordinating comprehensive care for patients.

SELF-DETERMINATION

The process by which individuals control their own lives and make their own choices regarding their care.

TELEPHONIC CASE MANAGEMENT

Healthcare management activities engaged through telephone communication.

UTILIZATION MANAGEMENT

The management of healthcare services to ensure medical necessity and appropriateness.

VOCATIONAL REHABILITATION

Services designed to help individuals with disabilities return to work.

WORKERS’ COMPENSATION

An insurance program providing compensation for employees injured on the job.