CMSA St. Louis Board Nominations 2021

It is that time of year again for new board members to step up and shine!  If you are interested in running for a position please fill out the attached information and submit it prior to December 15, 2020.

 

Thank you for your interest in the CMSS Board. This packet contains all of the forms needed to run for a Chapter position on the CMSS Leadership Team beginning in January 2021.

 

 

  

                                                                                          NOMINATION PACKET CHECKLIST

 

The following forms are included with this packet:

 

• Position Descriptions
• Election 2021 Form
• Summary Position Statement
• Biographical Information
• CMSS Confidentiality Statement
• CMSS Conflict of Interest Statement

 

The following should also be returned with Election Forms:

 

• Current Curriculum Vitae
• Contact information organizations on which you have served
• Copies of all Credentialing certificates & Applicable healthcare professional licenses

 

Please complete and return all items listed above

Send to:

Nominations Committee Chair/ President

Case Management Society of St. Louis

PO Box 854

Chesterfield, MO 63006

Must be postmarked by December 15, 2020

 

Or email to: [email protected]

 

PRESIDENT-ELECT [Serves a one year term, followed by a one year term as President and a one year term as Executive Director]

 

BASIC FUNCTION

Second highest ranking elected officer at the Society, and at the conclusion of the President’s term of office, automatically succeeds to the office of President. Performs such duties and assumes such responsibilities as may be assigned by the President and Board of Directors.

 

ADDITIONAL COMPETENCY

• Case Manager Member (A) in good standing.

 

RESPONSIBILITIES

       Refer to packet of positions and their roles and responsibilities

 

PRESIDENT [Serves a one year term of office, followed by a one year term as Immediate Past President/Executive Director]

 

BASIC FUNCTION

Chief elected officer of the Society. Exercises personal leadership in the motivation of other officers, board members, committee chairs, committee members and membership. Influences the establishment of goals and objectives for the organization during the term of office.

 

ADDITIONAL COMPETENCY

• Previously served as President-Elect
• Case Manager Member (A) in good standing

 

RESPONSIBILITIES

       Refer to packet of positions

 

TREASURER [Serves a two year term]

 

BASIC FUNCTION

Serves as a key member of the Executive Committee. Ensures the integrity of the fiscal affairs of the Society.  

 

ADDITIONAL COMPETENCY

• Possesses previous experience in budget and a good understanding of financial statements.
• Case Manager Member (A) in good standing

 

RESPONSIBILITIES

       Refer to packet of positions

 

TREASURER-ELECT

 

BASIC FUNCTION

Serves as a key member of the Executive Committee. Ensures the integrity of the fiscal affairs of the Society.  

 

ADDITIONAL COMPETENCY

• Possesses previous experience in budget and a good understanding of financial statements.
• Case Manager Member (A) in good standing

 

RESPONSIBILITIES

       Refer to packet of positions

 

COMMUNICATION CHAIRPERSON

 

BASIC FUNCTION

   Serves as a member of the Executive Committee. Ensures information is being delivered to the St. Louis

   Case Management Chapter members and participants.

 

   ADDITIONAL COMPETENCY

• Case Manager Member (A) in good standing

 

   RESPONSIBILITIES

         Refer to packet of positions

 

PUBLIC POLICY CHAIRPERSON

 

BASIC FUNCTION

   Serves as a member of the Executive Committee. Ensures news affecting our health care system, Case

   Management policies and proposals, nationally and locally is being delivered to the St. Louis members.

 

   ADDITIONAL COMPETENCY

• Case Manager Member (A) in good standing

 

    RESPONSIBILITIES

            Refer to packet of positions

 

EDUCATION CHAIRPERSON

 

BASIC FUNCTION

   Serves as a member of the Executive Committee. Ensures relevant and interesting topics are being offered                                                                                  

    6-7 times a year. These presentations will provide CCM credit to attendees. Webinars may be added.

 

   ADDITIONAL COMPETENCY

• Case Manager Member (A) in good standing

 

   RESPONSIBILITIES

         Refer to packet of positions

 

SPECIAL EVENT CHAIRPERSON

 

BASIC FUNCTION

   Serves as a member of the Executive Committee. Plans, organizes and leads events throughout the year.

     This committee will oversee the Case Management Appreciation Event in October and other gatherings

       That fosters and encourages networking and growth in the Chapter.

 

     ADDITIONAL COMPETENCY

• Case Manager Member (A) in good standing

 

     RESPONSIBILITIES

             Refer to packet of positions

  

 

 

SECTION I: Please print your information below and use additional paper where necessary.

 

Name:__________________________________Credentials________________

 

Company:_______________________________Title______________________

 

Phone:_________________________Fax:______________________________

 

Email:___________________________________________________________

 

Address:_________________________________________________________

 

City:____________________________State:________________Zip:_________

 

 MINIMUM CRITERIA

Future leaders must meet the following minimum criteria in order to be considered as a potential candidate.

 

1. Case manager ‘A’ member in good standing by the closing date of nominations
2. Willingness to contribute volunteer efforts to this professional society.
3. CMSS Membership requirements per board position descriptions.

 

I am interested in serving in the following position: (Please X one)

 

Terms of Office:

 

President-Elect (3 year term)        (   )

 

Treasurer-Elect (2 year term)    (   )

 

Communication Chair (     )       Public Policy Chair (     )       Education (   )       Special Events (  )

 

 

                                                            BIOGRAPHICAL INFORMATION

 

Please submit a typed brief bio completing EACH Section as Listed. If slated, this will be edited and incorporated into your profile on the final CMSS ballot for the 2018 election. It is your sole responsibility to list important information since CMSS has no other way of obtaining it.

 

Case Management Experience: ( 140 min./170 max. word count in nominee brochure if slated)

 

 

 

 

 

 

 

Honors/Awards: (max. of 4)

 

 

 

 

 

Professional Memberships including CMSS: (max. of 4)

 

 

Leadership Positions Held: (max. of 5) (CMSA Chapter Names (if applicable) will be listed as the official incorporated name)

 

 

 

 

 

I am aware of the leadership competencies and professional literacy’s required to fulfill the position indicated above. I am able to fulfill the time commitment. I further submit that if any information contained in my Election 2021 Form is found to be inaccurate, the Nominating Committee reserves the right to withdraw my name as a nominee from the position indicated above and from the selection process.

 

Signature:________________________________________________________ Date:______________________________

 

CONFIDENTIALITY of information will be maintained on all submitted Leadership Interest Forms

 

Please be sure to sign/complete and submit the following items/forms along with this application at the time of submission. (For use of slated)

 

Knowledgeable of CMSS Bylaws and Robert’s Rules of Order: YES____NO____

 

Computer literate and on-line accessible: YES____ NO____

 

 

 

 

                                                                   Board Confidentiality Policy

 

 

No CMSS board member shall knowingly disclose confidential information gained by reason of information shared at a board meeting. This includes details about:

 

• Contracts
• Operations
• Personnel
• Policies
• Affairs of the nonprofit

 

Information placed online in the Executive Committee, Board and Board and Committee Chair Forums is considered confidential and may not be shared with members or chapters.

 

Board handouts, faxed, emailed or mailed information or any other communication marked confidential may not be shared.

 

Information obtained while the Board is in executive session may not be shared.

 

Board Book Information is confidential.

 

No Board member shall accept employment or engage in any business or professional activity that might be expected to induce him or her to disclose confidential information acquired by reason of serving this board.

 

A breach of this policy will be reviewed by the Executive Board and may result in Board Dismissal.

 

My signature indicates I have read, understand and agree to follow the above policy.

 

 

 

________________________________________________________________Nominee’s Signature                                                                            Date

 

 

 

 

                                                      CONFLICT OF INTEREST POLICY & STATEMENT

 

 

Conflict of interest Policy

No board member shall use his/her position, or the knowledge gained therefrom, in such a manner that a conflict between the interest of the organization or any of its affiliates and his/her personal interests arises.

 

Each board member has a duty to place the interest of the organization foremost in any dealings with the organization and has a continuing responsibility to comply with the requirements of this policy.

 

Board members may not obtain for themselves, their relatives, or their friends a material interest of any kind from their association with the organization by virtue of their Board position.

 

If a board member has an interest in a proposed transaction with the organization in the form of a significant personal financial interest in the transaction or in any organization involved in the transaction, or holds a position as, director, or officer in any such organization, he/she must make full disclosure of such interest before any discussion or negotiation of such transaction.

 

Any board member who is aware of a potential conflict of interest with respect to any matter coming before the board may be excused during the discussion and/or voting periods in connection with the matter.

 

Disclosure

To implement this policy, board members of the organization will submit annual reports on the attached forms and if not previously disclosed, will make disclosure before any relevant board action.

 

These reports will be reviewed by the Executive Board, which will attempt to resolve any actual or potential conflict(s) and in the absence of resolution, refer the matter to the Board of Directors.

 

Conflict of Interest Statement

I have read the statement of policy regarding conflicts of interest.

 

To the best of my knowledge and belief, except as disclosed herewith, neither I nor any person with whom I have or had a persona or business relation ship is engaged in any transaction or activity or has any relationship that may represent a potential competing or conflicting interest, as defined in the statement of policy.

 

Further, to the best of my knowledge and belief, except a disclosed herewith, neither I nor any person with whom I have or had a personal, business, or compensated professional relationship intends to engage in any transaction, to acquire any interest in any organization or entity, or to become the recipient of any substantial gifs or favors that might be covered by the statement of policy regarding conflicts of interest.

• Without exception _____
• Except as described in the attached statement ____

 

Signature: _________________________________________                           Date: _______________