Reclaiming the “I” In Case Management: Unveiling Professional Identity Across the Discipline

Source: CMSA Today

Professional case managers stand at the critical crossroads of healthcare coordination, advocacy, and outcomes. Yet, despite their indispensable role in ensuring seamless transitions and improving quality of care, case managers often navigate their careers with an unclear or underdeveloped professional identity (PI). This ambiguity can impact how they perceive their value, how others regard their contributions, and how effectively they integrate into the broader interprofessional team.

To address this gap, our research explored the lived experiences, perceptions, and influences shaping the professional identity of case managers across healthcare settings. Through a mixed-methods study grounded in qualitative survey data and literature synthesis, we examined not only what it means to be a professional case manager today, but also what supports—or impedes—the development of a resilient, confident identity in this multifaceted field.

THE NEED FOR DEFINING THE CASE MANAGER’S IDENTITY

Professional identity refers to how individuals see themselves within their roles, encompassing values, skills, norms, and ethical commitments. While PI is well-theorized in nursing and medicine, case management has remained underrepresented in this discourse. Yet, case managers—spanning nursing, social work, rehabilitation, and other allied health disciplines—operate across increasingly complex systems and require a solid PI to support interdisciplinary collaboration, ethical decision-making, and patient-centered advocacy.

Our study found that many case managers deeply identify with their role, yet face persistent barriers including role ambiguity, inconsistent recognition, and limited leadership development pathways. These findings suggest that while the core values of case management are well understood by practitioners, organizational and educational systems have yet to fully support the maturation and sustainability of a strong professional identity.

METHODOLOGY AND SCOPE

The study leveraged the MacLeod Clark Professional Identity Scale (MCPIS), adapted with reflective and scenario-based questions for case managers. The survey drew responses from hundreds of participants across the U.S., representing diverse disciplines, settings, and experience levels. Our objectives were to:

Assess how case managers perceive their professional role and identity
Explore how internal and external factors influence PI development
Identify practical strategies for leadership growth, role clarity, and organizational support

Survey items explored team dynamics, leadership aspirations, peer relationships, career optimism, communication skills, and real-world application of knowledge.

KEY FINDINGS: STRENGTH IN IDENTITY, OPPORTUNITY IN GROWTH

1. High Identification with the Profession

An overwhelming 91.5% of respondents strongly identified as professional case managers, demonstrating a deep sense of belonging and alignment with the role. Similarly, 94.8% viewed their role as valuable and impactful, signaling a strong sense of professional purpose.

However, 21% of respondents reported weaker ties to professional peers, suggesting a need for more robust networking and community-building opportunities within the field.

2. Strong Team Engagement, with Gaps in Leadership Development

Case managers reported high levels of collaboration:

95.7% enjoyed working in teams
88.5% had actively participated in interprofessional care teams
91.2% believed they facilitated team collaboration

Despite this, only 56.1% saw themselves in leadership roles, and 43.9% were ambivalent or uninterested. These figures indicate a gap in leadership development and mentorship support. Many case managers contribute significantly to team dynamics but lack the confidence or support to step into formal leadership positions.

3. Resilience and Real-World Adaptability

Respondents showed strong competence in navigating complex team dynamics:

90.2% could identify inefficiencies in teams
74.7% applied knowledge effectively in real-world situations
75.5% embraced complexity and ambiguity in care settings

However, nearly one-quarter reported feeling overextended or contributing disproportionately to their teams—a potential early signal for burnout.

4. Barriers to Communication and Confidence

While most case managers felt confident communicating within teams, a significant minority (22%) reported challenges expressing their ideas or engaging in cross-functional collaboration. About 17% also indicated difficulty translating theory into practice, suggesting the need for training that bridges academic preparation with practical skills.

5. Influence of External Systems

Organizational culture, unclear role definitions, and technological disruption were repeatedly cited as external influences on professional identity. Rapid evolution in care delivery—especially shifts to digital tools and value-based care—require case managers to continuously adapt. A strong PI helps weather these transitions, yet many respondents reported limited organizational support for their evolving roles.

LITERATURE REVIEW: INSIGHTS FROM ACROSS DISCIPLINES

To contextualize our findings, the research team conducted a comprehensive literature review spanning nursing, social work, psychology, pharmacy, and occupational therapy. Key themes include:

Early Exposure Matters: Work-integrated learning and undergraduate IPE programs positively influence professional identity development. However, case management is rarely represented in these curriculums.
Professional Societies are Catalysts: Organizations like CMSA, ACMA, and CCMC play a vital role in promoting identity formation through certification, continuing education, and advocacy.
Measurement Tools are Lacking: While tools like the MCPIS and Nurse Professional Values Scale exist, few are fully validated for interdisciplinary case managers. There is a clear need for a dedicated PI assessment tool specific to case management.
Intersectionality and Inclusion: Gender, language, and cultural identity significantly impact how professionals perceive and perform their roles. The I-CARRE framework offers a promising model for ensuring inclusivity in PI development.
Reflective Practice and Narrative: Storytelling, mentorship, and reflection emerge as powerful tools for affirming identity, processing challenges, and maintaining professional resilience.

IMPLICATIONS FOR PRACTICE: BUILDING A STRONGER FOUNDATION

Educational Institutions

Integrate case management content into nursing, social work, and allied health curricula
Develop interprofessional simulation exercises that emphasize the case manager’s role
Offer structured mentorship and professional identity programs during clinical training

Healthcare Organizations

Create career ladders with clear titles, competencies, and advancement pathways
Provide leadership development and advocacy training for aspiring leaders
Recognize and celebrate National Case Management Week and individual contributions

Professional Organizations

Advocate for standardized role definitions across healthcare systems
Develop a dedicated PI assessment tool for case managers
Increase representation of case managers on healthcare boards and policy forums

RECOMMENDATIONS

Based on the findings, we recommend:

Career Development Pathways: Formalized advancement tracks from novice to expert, including mentorship and role-specific leadership training.
Standardized Education and Credentialing: Broader promotion of certifications (CCM, ACM, ICCS) and continuing education in communication, technology, and advocacy.
Visibility and Recognition: Strategic branding efforts to promote the case management role across care settings and among executive leadership.
Interprofessional Integration: Positioning case managers as equal partners in care coordination and organizational strategy, supported by training in team communication and systems thinking.
Research and Evaluation: Continued study of PI development, especially its impact on burnout, retention, and patient outcomes.

MOVING FORWARD: A SHARED IDENTITY FOR A VITAL PROFESSION

The research confirms what many case managers intuitively know: their professional identity is strong—but not always recognized. By investing in structured support for identity formation and leadership growth, we can ensure that case managers are not only present at the table, but influential in shaping healthcare’s future.

This project is not an endpoint, but a beginning. It opens the door for further dialogue, deeper research, and system-level changes that elevate the case management profession. As we advocate for our patients, we must also advocate for ourselves—asserting the “I” in our identity as case managers with clarity, confidence, and pride.

Dr. Colleen Morley, DNP, RN, CCM, CMAC, CMGT-BC, CMCN, ACM-RN, FCM, FAACM, is an accomplished nurse leader and nationally recognized expert in case management, readmission reduction strategies and care transitions. She serves as Associate Chief Clinical Operations Officer for Continuum of Care at UI Health and is a Past National President of CMSA. A published author and educator, she has received multiple awards for her advocacy and leadership. With more than 25 years of nursing experience, Dr. Morley is dedicated to advancing the profession through mentorship, policy reform, and strategic innovation in care coordination, utilization management, and patient outcomes across the healthcare continuum.

Dr. Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, wholistic health equity, quality, and trauma-informed leadership. She is a content-developer, professional speaker, author, and educator who is a faculty member, academic advisor, and IRB coordinator for the Doctoral of Behavioral program at Cummings Graduate Institute of Behavioral Health Studies. She is also an adjunct faculty member at George Mason University’s School of Public Health. Dr. Fink-Samnick is a member of the PMCJ editorial board and serves as editor of the journal’s HeartBeat of Case Management department. She also serves in national leadership and consultant roles across the industry, including as current Vice-Chair for CMSA’s DEIB Core Committee. Further information is available on her LinkedIn bio (https://www.linkedin.com/in/ellenfinksamnick/) or her website (http://www.efssupervisionstrategies.com/).

Dr. Lisa Parker-Williams, DNP, RN, MBA, CCM, is a highly accomplished registered nurse with more than three decades of experience. Known for her strategic, hands-on, and collaborative leadership style, she has a proven track record of improving health outcomes, reducing costs, and elevating patient experience.

Dr. Parker-Williams is a supervisor for a clinical case management team at a top healthcare payer, where she is dedicated to empowering her team to be strong advocates for members. In addition to her corporate responsibilities, Lisa provides independent consultation to nurses, guiding them in their professional pursuits. She is actively involved in the New Jersey CMSA chapter.

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