Foundations of Case Management

$897.00

A case manager must have a broad knowledge of reimbursement methods to perform her job effectively. She must understand how healthcare reimbursement is tied to quantifiable outcomes. She must also understand the clinical and financial resources available to her patient, the eligibility criteria for receiving those resources, as well as the limitations and restrictions to the resources. When the needs of the patient and the obvious financial resources available do not match, the case manager must be aware of alternate resources available to the patient.

You will learn basic insurance coverage and principles you need to begin working as a case manager. This will help familiarize you with the terminology, principles, concepts, and alternative financial resources, creating a foundation you can build on during your case management career.

Description

The Foundations of CM course covers everything you need to know to begin working as a case manager including:

  • Case Management Standards of practice
  • Legal and Regulatory Requirements
  • Healthcare and disability-related legislation important to Case managers
  • Principles of Case Management Practice
  • The Case Management Process
  • Definitions, Philosophy, and Goals of Case Management
  • The Utilization Management Process
  • Factors used to determine the CM’sacuity and severity of an illness or injury
  • Various levels of care and the criteria the client must meet to be approved for each level.
  • The various government agency regulations and requirements associated with discharge planning and transitions of care that case managers must know
  • The Various rehabilitation delivery systems available and the criteria for eligibility for each
  • How to apply proper documentation to case management cases
  • Behavioral Change Theories and Stages
  • Psychosocial Aspects of Chronic Illness and Disability
  • Crisis Intervention Strategies

After completing this course you will be able to:

  • Create case management plans of care that are specific to your client
  • Assess clients for social determinants of health and describe interventions CM’s may implement to address these.
  • Compare the behavioral change theories case managers use.
  • Determine your client’s health belief as related to the HBM and use this information to determine where to focus your efforts to induce change.
  • Distinguish between an adaptive family and a maladaptive family and the implications of each on your cm practice
  • Describe interventions you can take if you identify that a client’s caregiver is at increased risk for abusing the client that may reduce the threat of abuse.
  • Understand the implications of a client with dual diagnosis
  • Describe what constitutes a crisis and interventions you can implement to assist a client in crisis.

But that’s not all…

A case manager must have a broad knowledge of reimbursement methods to perform her job effectively. She must understand how healthcare reimbursement is tied to quantifiable outcomes. She must also understand the clinical and financial resources available to her patient, the eligibility criteria for receiving those resources, as well as the limitations and restrictions to the resources. When the needs of the patient and the obvious financial resources available do not match, the case manager must be aware of alternate resources available to the patient.

You will learn basic insurance coverage and principles you need to begin working as a case manager. This will help familiarize you with the terminology, principles, concepts, and alternative financial resources, creating a foundation you can build on during your case management career.

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