- Certified Case Manager Client Advocacy and Engagement Questions and Answers Flashcards

When advocating for a client denied a medically necessary service, what is the most effective first approach?

Answer: Gathering clinical evidence and submitting a peer-to-peer review request

A peer-to-peer review with supporting clinical evidence allows direct clinical discussion with the reviewing physician.

Which engagement strategy is most effective for repeatedly disengaged clients?

Answer: Conduct a barriers assessment to identify root causes of disengagement

A barriers assessment identifies root causes such as transportation, childcare, or health literacy issues.

What is 'shared decision-making' in client engagement?

Answer: A collaborative process where client and healthcare team exchange information and deliberate on options

Shared decision-making is a collaborative process where clients and providers jointly deliberate on treatment options.

A client feels unheard by their medical team. How should the case manager respond?

Answer: Validate feelings and offer to facilitate a meeting between client and care team

Validating feelings and facilitating improved communication addresses the core issue.

Which ethical principle requires case managers to disclose potential conflicts of interest?

Answer: Veracity and transparency

Veracity and transparency require disclosure of any conflicts that could affect advocacy.

How should a case manager engage a client resistant to treatment due to cultural or religious beliefs?

Answer: Explore beliefs respectfully, provide culturally sensitive education, and seek compatible alternatives

Respectfully exploring beliefs and seeking culturally compatible alternatives demonstrates client-centered advocacy.