DFW CMSA
2008 Case Manager of the Year
Minimum Criteria:
§ Three years (3) active DFW CMSA membership. 20 pts
§ Type “A” membership at time of nomination. 20 pts
(Those making nominations may be type “A” or “B” members.)
Professional Criteria:
§ License or Certification in Clinical/Professional field. 10 pts
§ National Specialty Certification. 10 pts
§ Case Management Certification. 10 pts
§ Three years (3) current Case Management experience. 10 pts
Distinguished Service:
§ DFW CMSA Officer (note each office and term year). 30 pts
§ DFW CMSA Board of Directors (note term year). 20 pts
§ DFW CMSA Committee Chair (note committee and term year). 30 pts
§ DFW CMSA Committee Member (note effective date). 20 pts
§ National CMSA Officer and/or Committee chair (note position/year). 30 pts
§ National CMSA Committee Member (note committee and term year). 20 pts
Excellence in Case Management Practice:
§ Enhances the profession of Case Management through specific
contributions to the profession. 5 pts
§ Significantly and positively impacts Case Management practice
in a particular setting. 5 pts
§ Develops new and innovative management approaches to a commonly
recognized barrier to effective Case Management. 5 pts
§ Exceeds usual expectations in the training or mentoring of
Case Managers. 5 pts
§ Exceeds usual expectations in the supervision or management
of Case Managers. 5 pts
Exceeds usual expectations in the delivery of Case Management
services to clients resulting in improved health care outcomes/cost efficiency. 5 pts
§ Significantly impacts effective communication with other professional groups. 5 pts
§ Is recognized in a specific area of Case Management practice as upholding 5 pts
the highest ethical and professional standards.
Nominations should be presented in an organized format per category. “Excellence in Case Management Practice” may include statements from colleagues, co-workers, supervisors or others able to substantiate the Candidate’s contribution to the field of Case Management.
Nominations with completed documentation must be received by January 31, 2008
Submit documentation to:
Linda Hackathorn
1009 Springdale Road
Bedford, TX 76021
For additional information contact Linda Hackathorn, (817) 545-0535. You may speak with any previous Case Manager of the Year recipient: Cheryl Acres, Kay Rhodes, Judy Robinson; Kathy Kucera; BK Kizziar; Patti Grady, or Julie Carroll.
Documentation MUST be included with Nomination form to be considered.
2008 DFW CMSA
Case Manager of the Year
Nomination Form
Candidate must meet minimum criteria. The scoring process utilizes objective point driven criteria. Please provide information that will support the nominee’s qualifications to be the recipient of the award. Nomination forms received without substantiating documentation cannot be considered.
Name of Nominee:_____________________________ Credentials:__________________
Address:________________________________________________________________
City:________________ State: ______________Zip: ________Phone:______________
Minimum Criteria:
1. Three years (3) active DFW CMSA membership. ___yes ___no
2. Type “A” membership at time of nomination. ___yes ___no
Professional Criteria:
1. License or Certification in Clinical/Professional field. ___yes ___no
2. National Specialty Certification. ___yes ___no
3. Case Management Certification. ___yes ___no
4. Three years (3) current Case Management experience. ___yes ___no
Distinguished Service:
1. DFW CMSA Officer. ___yes ___no
2. DFW CMSA Board of Directors. ___yes ___no
3. DFW CMSA Committee Chair. ___yes ___no
4. DFW CMSA Committee Member. ___yes ___no
5. National CMSA Officer and/or Committee chair. ___yes ___no
6. National CMSA Committee Member. ___yes ___no
*Attach documentation substantiating each position claimed including term year.
Excellence in Case Management Practice:
Provide documentation for demonstrated excellence in Case Management practice. This may include copies of published articles, evidence of educational/professional presentation, community service, letters of recommendations from supervisors, co-workers, employees or others as well as descriptions of innovative efforts to further the professionalism of Case Management and uphold the ethical and professional standards of the industry.
Professional references:
Provide two (2) professional references (not including the Nominator) that could confirm the information provided for the nomination.
1. Name:_____________________Relationship:_______________Phone:___________
2. Name:_____________________Relationship:_______________Phone:___________
Nominator:
To the best of my knowledge, the information submitted is true and accurate.
Signature:_______________________ Printed Name:__________________________
Phone:_______________________ Relationship to Nominee:___________________