PSPINM012
Manage case direction and outcomes


Application

This unit describes the skills required to undertake case management of injured workers through return to work or other alternatives. It includes developing strategic case management plans.

This unit applies to those working in public sector roles but may be applied to anyone working in a similar organisational context.

The skills and knowledge described in this unit must be applied within the legislative, regulatory and policy environment in which they are carried out. Organisational policies and procedures must be consulted and adhered to.

Those undertaking this unit would work autonomously while performing complex tasks in a range of contexts.

No licensing, legislative or certification requirements apply to unit at the time of publication.


Elements and Performance Criteria

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section.

1. Develop strategic case management plans

1.1 Develop case management plans to reflect the initial assessment of needs.

1.2 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.

1.3 Include avenues for appeal and procedures for grievances or complaints in plans.

1.4 Determine and include strategies for monitoring and changing plans.

1.5 Consider cultural impact into all aspects of case management plans.

1.6 Establish and implement strategies for obtaining and monitoring service providers.

2. Manage case directions and outcomes

2.1 Implement strategies to monitor the effectiveness of case management processes against agreed goals, relevant services and programs, and client and stakeholder satisfaction.

2.2 Monitor rehabilitation and return to work plans to ensure they remain consistent with the determined strategic direction of case.

2.3 Assess the need for changes in case plans, including the need for continued intervention, and develop strategies for alternative action as required.

2.4 Monitor payments to injured workers and adjust as required.

2.5 Consider alternatives and recommend them if required, should the rehabilitation and return to work process fail.

2.6 Provide advice on all aspects of case management including advice on legislative and risk management issues.

3. Manage complex cases

3.1 Tailor case management and return to work plans to the specific needs of complex cases.

3.2 Use high-level negotiation, mediation and conflict management skills to manage objectives and outcomes in complex cases.

3.3 Obtain expert assistance as required and facilitate case conferences to ensure the best outcome for complex case management.

3.4 Take a risk management approach in the allocation of additional resources to complex cases to ensure value for money in the rehabilitation process.

Evidence of Performance

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


Evidence of Knowledge

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


Assessment Conditions

This unit contains no specific industry-mandated assessment conditions. Guidance on suggested and recommended conditions and methods can be found in the Implementation Guide.

Assessors must satisfy the NVR/AQTF mandatory competency requirements for assessors


Foundation Skills

Foundation skills are embedded within the elements and performance criteria of this unit.


Competency Field

Injury management