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Elements and Performance Criteria

1. Develop strategic case management plans
   • Develop case management plans to reflect the initial assessment of needs.
   • Include action plans in case management plans as required, and identify the full range of short, medium and long term goals that focus on the achievement of the best possible outcome for claim resolution.
   • Include avenues for appeal and procedures for grievances or complaints in plans.
   • Determine and include strategies for monitoring and changing plans.
   • Consider cultural impact into all aspects of case management plans.
   • Establish and implement strategies for obtaining and monitoring service providers.
2. Manage case directions and outcomes
   • Implement strategies to monitor the effectiveness of case management processes against agreed goals, relevant services and programs, and client and stakeholder satisfaction.
   • Monitor rehabilitation and return to work plans to ensure they remain consistent with the determined strategic direction of case.
   • Assess the need for changes in case plans, including the need for continued intervention, and develop strategies for alternative action as required.
   • Monitor payments to injured workers and adjust as required.
   • Consider alternatives and recommend them if required, should the rehabilitation and return to work process fail.
   • Provide advice on all aspects of case management including advice on legislative and risk management issues.
3. Manage complex cases
   • Tailor case management and return to work plans to the specific needs of complex cases.
   • Use high-level negotiation, mediation and conflict management skills to manage objectives and outcomes in complex cases.
   • Obtain expert assistance as required and facilitate case conferences to ensure the best outcome for complex case management.
   • Take a risk management approach in the allocation of additional resources to complex cases to ensure value for money in the rehabilitation process.
4. Develop strategic case management plans
   • Develop case management plans to reflect the initial assessment of needs.
   • Include action plans in case management plans as required, and identify the full range of short, medium and long term goals that focus on the achievement of the best possible outcome for claim resolution.
   • Include avenues for appeal and procedures for grievances or complaints in plans.
   • Determine and include strategies for monitoring and changing plans.
   • Consider cultural impact into all aspects of case management plans.
   • Establish and implement strategies for obtaining and monitoring service providers.
5. Manage case directions and outcomes
   • Implement strategies to monitor the effectiveness of case management processes against agreed goals, relevant services and programs, and client and stakeholder satisfaction.
   • Monitor rehabilitation and return to work plans to ensure they remain consistent with the determined strategic direction of case.
   • Assess the need for changes in case plans, including the need for continued intervention, and develop strategies for alternative action as required.
   • Monitor payments to injured workers and adjust as required.
   • Consider alternatives and recommend them if required, should the rehabilitation and return to work process fail.
   • Provide advice on all aspects of case management including advice on legislative and risk management issues.
6. Manage complex cases
   • Tailor case management and return to work plans to the specific needs of complex cases.
   • Use high-level negotiation, mediation and conflict management skills to manage objectives and outcomes in complex cases.
   • Obtain expert assistance as required and facilitate case conferences to ensure the best outcome for complex case management.
   • Take a risk management approach in the allocation of additional resources to complex cases to ensure value for money in the rehabilitation process.

Performance Evidence

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the candidate must demonstrate evidence of performance of the following on at least one occasion.

applying legislation, regulations and policies relating to managing case direction and outcomes

applying case management principles to injury management

using communication with diverse stakeholders' including negotiation and problem-solving

dealing with and/or managing difficult people

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Knowledge Evidence

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the depth of knowledge demonstrated must be appropriate to the job context of the candidate.

public sector legislation including work health and safety and environment, regulations, policies, procedures and guidelines relating to injury management

privacy legislation

procedures to ensure confidentiality and security of information

public sector management acts

industrial law/industrial relations practice

reporting requirements

case management principles and practices relating to injury management

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