The Basics

This standard set forth qualifications for case management supervisors.  A supervisor must have either (1) a health-field bachelors degree plus an applicable license, or (2) CM certification, or (3) clinical specialty certification plus 3 years of CM experience.  In addition, if the supervisor has 3 years of supervisory experience, he/she should have CM certification.

So, what are the URAC-approved certifications under CM 4(a)(ii)?  Click here to get the latest list. 

URAC Accreditation Tips

This standard is weighted "4".  Note that the three subsections under (a) are alternative means to obtaining the "primary" points for this standard.  Only one is required.

The documentation for desktop review is straightforward:

• Job description
• Current CM department organization chart
• The P&P for credentials verification (probably the same one you used for the comparable Core standard, Core 6 in v. 2.1 and Core 30 in v. 3.0)

Make sure that the job description for the CM manager requires at least one of the components of 4(a) and the requirement of 4(b).  As I've said elsewhere, simply having your CM manager meet these qualifications is not sufficient -- you must have the requirement in the job description itself.

The onsite reviewer will verify compliance with this standard as she's verifying all the other personnel records standards.  Click here for the Core v.2.1 discussion of those records.