Care managers provide crucial services to ensure effective care delivery and efficient resource utilization. This interactive, self-paced online course explores care management functions that underpin hospital operations, describes why they are important, and delivers innovative strategies in how to execute them efficiently and effectively.
Case Management Training Made Easy – Take the Whole Course or Individual Modules
Developed by experts in hospital case management, in collaboration with the California Hospital Association, this self-paced curriculum comprises six modules:
- Monitoring Productivity and Quality
- Audits and Reports
- Payor and Reimbursement Factors in Care Management
- Care Delivery, Regulation, and Compliance
- Integrating Quality Initiatives
- Risk Management
This course is perfect for RN case managers, social work case managers and care coordinators working in acute care, skilled nursing, long-term care or clinic settings
Learners will master a wide range of learning objectives, including how to:
- Identify areas of needed improvement in healthcare quality in their organization
- Articulate some of the key performance indicators and quality metrics for reporting and analysis
- Discuss quality management tools and their application in different circumstances
- Explain how the Utilization Management Committee can be an important part of quality management
- Understand the importance of collecting metrics and the five main areas of metric tracking: compliance, quality improvement, satisfaction, cost, and productivity
- Understand the relationship between data and strategic planning, and formulate strategic plans based upon data
- Understand the components that go into payment and clinical documentation
- Define classifications including Medicare Severity-Diagnosis Related Group (MS DRG) and All Patients Refined Diagnosis Related Groups (APR DRG) as well as additional classifications within the DRG system
- Describe audit and survey practices for correct payment (including pre- and post-payment, as well as those who support the process including Recovery Audit Contractors (RACs), Medicare Administrated Contractors (MACs), and Medicaid Integrity Contractors (MICs), as well as other auditing and reimbursement programs)
- Describe Medicare and its parts including Part A, B, C, D, and Medigap programs/supplemental insurances, as well as Medicaid and how these relate to payment and clinical documentation
- Describe laws and statutes that have impact health care regulation including the Patient Protection and Affordable Care Act (PPACA), the Health Insurance Portability and Accountability Act (HIPAA), the Emergency Medical Treatment and Active Labor Act (EMTALA), as well as those pertaining to mental health, addiction
- Identify what processes are required for a compliant utilization management process
- Describe key components outlined in the CMS State Operating Manual under the Conditions of Participation to participate with Medicaid and Medicare
- Describe important rules, certifications, and notifications including the Two Midnight Rule, the 20-Day Certification, Medicare Outpatient Observation Notice (MOON), Important Message from Medicare (IMM), The Three Midnight Qualifying Stay
- Identify key factors related to prioritizing and planning quality initiatives, and provide examples of potential clinical quality initiatives
- Demonstrate an understanding of the importance of an interdisciplinary approach and list key members of the healthcare quality team
- Describe the implementation of the “plan, do, study, act” (PDSA) cycle in the context of healthcare quality
- Identify what processes are required for regulatory compliance, what constitutes risk, and options for addressing potentially unsafe discharges
Care Excellence’s courses for hospital care managers allow organizations to optimize employee training by providing high quality, engaging online education in an interactive learning management system that utilizes case studies, pre- and post-tests, and other resources to maximize learning and retention.
Call us at 760-750-4006 to purchase multiple modules or if you need assistance designing a custom combination of solutions!
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Course Modules |
Care Excellence’s courses for hospital care managers have been designed to give you exactly what you need, when you need it. Utilizing a state-of-the-art learning management system, the curriculum is interactive and engaging, utilizing case studies, pre- and post-tests, and other resources to maximize learning and retention. Take the entire Administrative Functions course, or laser focus your training on any combination of the modules below to address specific challenges.
Call us at 760-750-4006 to purchase multiple modules or if you need assistance designing a custom combination of solutions!
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Fast Facts |
The Administrative Functions course is available online and can be purchased both in its entirety or piecemeal by modules. Please call us for more information.
| Is taught: | Completely online, via self-paced courses |
| Begins: | Online modules are available immediately upon registration |
| Costs: | $448 per course (see module description for individual pricing) |
| Requires: | Computing skills sufficient to complete graduate work, access to a computer with an Internet connection. |
| Is ideal for: | New or experienced inpatient care managers, care coordinators, or discharge planners working in hospitals, skilled nursing centers, long-term care facilities, and more |
| Provides: | 16 Continuing Education hours upon successful completion |
| Refund Policy: | Course is non-refundable once it has been accessed |