PSPIM502A - Manage case direction and outcomes

PSPIM502A
Manage case direction and outcomes

This unit covers case management of injured workers through return to work or other alternatives. It includes developing strategic case management plans, managing case direction and outcomes and managing complex cases.In practice, managing case direction and outcomes may overlap with other generalist or specialist public sector work activities such as acting ethically, complying with legislation, delivering client services, managing resources, undertaking research and analysis, project management.No licensing, legislative, regulatory or certification requirements apply to this unit at the time of publication

Application

Not applicable.

Prerequisites

Not applicable.

Elements and Performance Criteria

ELEMENT	PERFORMANCE CRITERIA
1. Develop strategic case management plans	1.1 Case management plans are developed to reflect the initial assessment of needs in accordance with legislation, policy and procedures. 1.2 Action plans are included 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. 1.3 Avenues for appeal and procedures for grievances/complaints are contained in plans. 1.4 Strategies for monitoring and changing plans are established and included. 1.5 Cultural considerations are integrated into all aspects of case management plans. 1.6 Strategies for obtaining and monitoring service providers are established and implemented.
2. Manage case directions and outcomes	2.1 Strategies are implemented to continually monitor the effectiveness of case management processes against agreed goals, relevant services and programs, and client and stakeholder satisfaction. 2.2 Rehabilitation and return to work plans are monitored to ensure they remain consistent with the determined strategic direction of case. 2.3 The need for changes in case plans, including the need for continued intervention, is assessed and strategies for alternative action are developed as required. 2.4 Payments to injured workers are monitored and adjusted as required in accordance with legislation, policy and procedures. 2.5 Alternatives are considered and recommended if required, should the rehabilitation and return to work process fail. 2.6 Advice on all aspects of case management is provided including advice on legislative and risk management issues.
3. Manage complex cases	3.1 Case management and return to work plans are tailored to the specific needs of complex cases in accordance with legislation, policy and procedures. 3.2 High-level negotiation, mediation and conflict management skills are used to manage objectives and outcomes in complex cases. 3.3 Expert assistance is obtained as required and case conferences are facilitated to ensure the best outcome for complex case management. 3.4 A risk management approach is taken in the allocation of additional resources to complex cases to ensure value for money in the rehabilitation process.

Required Skills

This section describes the essential skills and knowledge and their level, required for this unit.

Skill requirements

Look for evidence that confirms skills in:

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/managing difficult people

responding to diversity, including gender and disability

applying procedures relating to occupational health and safety and environment in the context of injury management

Knowledge requirements

Look for evidence that confirms knowledge and understanding of:

legislation, 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

equal employment opportunity, equity and diversity principles

public sector legislation such as occupational health and safety and environment in the context of injury management

Evidence Required

The Evidence Guide specifies the evidence required to demonstrate achievement in the unit of competency as a whole. It must be read in conjunction with the Unit descriptor, Performance Criteria, the Range Statement and the Assessment Guidelines for the Public Sector Training Package.
Units to be assessed together	Pre-requisite units that must be achieved prior to this unit:Nil Co-requisite units that must be assessed with this unit:Nil Co-assessed units that may be assessed with this unit to increase the efficiency and realism of the assessment process include, but are not limited to: PSPETHC501B Promote the values and ethos of public service PSPGOV502B Develop client services PSPGOV503B Coordinate resource allocation and usage PSPGOV504B Undertake research and analysis PSPGOV505A Promote diversity PSPLEGN501B Promote compliance with legislation in the public sector PSPPM502B Manage complex projects
Overview of evidence requirements	In addition to integrated demonstration of the elements and their related performance criteria, look for evidence that confirms: the knowledge requirements of this unit the skill requirements of this unit application of the Employability Skills as they relate to this unit (see Employability Summaries in Qualifications Framework) case management related to injured workers in a range of (3 or more) contexts (or occasions, over time)
Resources required to carry out assessment	These resources include: legislation, policy, procedures and protocols relating to injury management case studies and workplace scenarios to capture the range of situations likely to be encountered when undertaking case management related to injured workers
Where and how to assess evidence	Valid assessment of this unit requires: a workplace environment or one that closely resembles normal work practice and replicates the range of conditions likely to be encountered when managing case direction and outcomes for injured workers, including coping with difficulties, irregularities and breakdowns in routine case management related to injured workers in a range of (3 or more) contexts (or occasions, over time) Assessment methods should reflect workplace demands, such as literacy, and the needs of particular groups, such as: people with disabilities people from culturally and linguistically diverse backgrounds Aboriginal and Torres Strait Islander people women young people older people people in rural and remote locations Assessment methods suitable for valid and reliable assessment of this competency may include, but are not limited to, a combination of 2 or more of: case studies portfolios questioning scenarios authenticated evidence from the workplace and/or training courses
For consistency of assessment	Evidence must be gathered over time in a range of contexts to ensure the person can achieve the unit outcome and apply the competency in different situations or environments

Range Statement


The Range Statement provides information about the context in which the unit of competency is carried out. The variables cater for differences between States and Territories and the Commonwealth, and between organisations and workplaces. They allow for different work requirements, work practices and knowledge. The Range Statement also provides a focus for assessment. It relates to the unit as a whole. Text in bold italics in the Performance Criteria is explained here.
Legislation, policy and procedures may include:	workers rehabilitation/compensation legislation allied legislation such as occupational health and safety acts, regulations and associated standards privacy legislation legislation and standards to ensure confidentiality and security of information performance standards rehabilitation and return to work manual public sector legislation and standards codes of conduct codes of ethics
Service providers may include:	approved/accredited rehabilitation providers occupational therapists physiotherapists rehabilitation counsellors psychologists ergonomists
Monitoring effectiveness may include:	facilitating review activities obtaining feedback from stakeholders liaison with service providers feedback from injured worker providing advice on return to work plans
Stakeholders may be:	supervisor/manager doctor/specialist claims management Comcare case manager return to work coordinator approved rehabilitation provider union family/partner
Return to work plan is:	agreed blueprint for injured worker to return to work with: suitable duties physical restrictions agreed hours supervision arrangements
Adjustment of payments may include:	increasing payments decreasing payments discontinuing payments
Alternatives may include:	termination on grounds of invalidity redemption of/capital payment for liability
Complex cases may include:	multiple injuries/illness psychiatric illness psychological injury claims involvement of a wide range of other agencies cases with high public/political sensitivity cases where there are fraud indicators industrial/human resource issues loss of skills performance issues stuck cases

Sectors

Not applicable.

Competency Field

Injury Management.

Employability Skills

This unit contains employability skills.

Licensing Information

Not applicable.