Another key policy of Japan's LTCI is care management. Care management is a professional service to coordinate different services provided by different providers to accommodate geographically dispersed home settings within a limit of allocated budget.

Care management was first implemented by the U.K. in its Community Care Act 1990. This was part of the welfare reform promoted by Thatcher administration. Care management was expected to be important for Japan's LTCI system because the benefit includes not only non-medical services such as home help but also medical services such as visiting nursing services. This is a sharp difference from German LTCI, which provides purely non-medical services and therefore lacks official care management system.

To cater to the need for need assessment and care management, a considerable number of skilled experts were needed. A new professional called "Care manager" or "kaigo shien senmon in" was created and the first qualification exam was started in September 1998. Already three exams were held and the number grew to over 200,000. Qualification will be given professionals who already possess health or welfare related lincenses and have at least five years of clinical experience