The Role of Case Management in Disease Management (DM1013)

Course Format

This course is online. All course material is available online and is accessible immediately after purchase from your account homepage. Certificate of Completion is available immediately upon passing the exam.

Course Overview

Outline:

• Introduction
• A Historical Perspective
• A New Frontier
• Proactive Case Management
• Example 1: Risk Assessment and Case Selection
• Example 2: Patient Education
• The Process of CM with Disease Management Systems
• Identification of at-risk members
• Health Assessment and Evaluation of Identified Population
• Determination of Benefits
• Development of Clinical Pathways and Disease Management
• Interventions
• Implementing the Disease Management Plan
• Administration of Care Plan / Demand Management
• Compliance Monitoring and Management
• Outcomes Measurement
• Disease Management Tools
• Patient-Related Tools
• Report Cards
• Pathways
• Demand Management
• Education / Prevention / Wellness Programs
• Case Management Tools
• Health Risk Assessments
• Computerized Patient Records
• Clinical Guidelines
• Selection Criteria
• Outcomes Tracking
• Cost-Benefit Analysis
• Evolution of Roles, Responsibilities, and Skull Sets
• Summary

Course Objectives

1. Define the Role of Case Managers in Diseae Management


2. Identify the 5 Phases in the Managed Care Timeline: from Utilization Review (Discovery)to Wellness Management (Disease Prevention)


3. Explain the Process of Case Managemnt within Disease Management Systems


4. Identify and Describe the 6 most common Case Management Tools:
   (1) Health Risk Assessment
   (2) Computerized Patient Records
   (3) ClinicalGuidelines
   (4) Selection Criteria
   (5) Outcomes Tracking
   (6) Cost-Benefit Analysis


5. Discuss the evolution in the Role and Skills of the Case Manager to Disease Management Specialist