A Conversation with Toresha Peterson, RN, MS, CCM

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BY ANNE LLEWELLYN, MS, BHSA, RN-BC, CCM, CRRN

Each month in this column, we highlight an up-and-coming case management leader. The criterion for a nomination is that the professional has contributed to the practice of case management and has inspired others to step up and become leaders in their area of case management.

In this issue, Past President of the Case Management Society of America Anne Llewellyn nominates Toresha (Torie) Peterson RN, MS, CCM. Anne and Torie worked together on a project this year where Anne was able to see Torie’s experience, organizational skills and ability to clearly explain the project to numerous people involved culminate into a successful event. Here are a few questions that will give you insights into this dynamic leader. Congratulations, Torie.

Q. WHAT IS YOUR CURRENT ROLE IN THE PRACTICE OF CASE MANAGEMENT?

I am currently director of compliance for a PACE Organization. So technically I am indirectly linked to case management. A director of compliance is the “monitor” for an organization. We maintain a high knowledge of the current federal and state regulations to allow us to care for some of the most vulnerable populations in the community.

Q. IN WHAT AREA OF CASE MANAGEMENT HAVE YOU HAD THE MOST SUCCESS?

The area of case management in which I have been most successful is within post-acute care. Specifically, long-term services and support within the community.

Q. HOW DO YOU SEE CASE MANAGERS SHOWING THEIR VALUE IN A VALUE-BASED ENVIRONMENT?

Case managers are central to its success. It is vitally important that CMs manage the overall care of the patients we serve. Our unique training and skillset allow us to address the clinical, social and economic needs of the patients and obtain consensus in the direction of the care being provided.

Q. WHERE DO YOU SEE THE PRACTICE OF CASE MANAGEMENT GOING IN THE NEXT FIVE YEARS?

I see CM growing in the value-based space. As more programs report out on their successful partnerships, we will see that case managers were key in realizing that success. I also see CMs at the forefront of long-term COVID management and care.

Q. WHAT CHALLENGES HAVE YOU FACED IN YOUR CAREER? HOW DO YOU ADDRESS THEM?

The biggest challenge I faced was proving my value. I learned early on that quantifying my decisions was key to demonstrating my worth. An ongoing review and documentation of the decisions I have influenced and the information that I provided to patients, caregivers, practitioners and clients is key to overcoming those challenges. Early on it started with quantifying not only cost but clinical evidence of improvements made in a patient’s care.

Q. HOW HAS BELONGING TO THE CASE MANAGEMENT SOCIETY OF AMERICA ENHANCED YOUR CAREER?

Knowledge and networking. The diverse areas of CM are addressed within CMSA. You obtain knowledge in your current practice as well as other areas of CM. I get lost in the knowledge area of the website. I appreciate the fact that I don’t have to look to other websites. I can and always start my search with CMSA.org.

Toresha Peterson, RN, MS, CCMhas 25 years of nursing and case management experience in various healthcare settings. She has an extensive background in program development, process improvement, redesign and the development and interpretation of healthcare quality standards and performance measures.

She has successfully led various teams in implementing many process improvement initiatives with a goal to improve efficiency and quality of care within various healthcare organizations. Her passion is providing care and support to the most vulnerable populations. She has a dedication to the profession, as a nurse, a case manager and an administrator and is committed to discovering innovative health care solutions.

Currently, she is director of compliance and regulatory affairs at Welbe Health, a PACE (Program for All-inclusive Care for the Elderly) organization.

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