This course, HM6000B, is the SECOND of 3 parts of the QPCM CERTIFICATE OF ACHIEVEMENT PROGRAM FOR ENTRY LEVEL CASE MANAGERS. Upon completion of all 3 parts, you will receive a Certificate of Achievement that can be submitted along with your Resume for entry level Case Management jobs. This Certificate confirms your successful completion of a comprehensive introductory course in Case Management. You will be able to talk intelligently with hiring authorites about the basics of case management and you will be better prepared and more confidant when applying for entry level positions. HM6000B: Case Management Essentials (Part 2) - Processes and Activities 18 Contact Hours TAKE PART 2 NOW !
SEE THE OTHER PARTS HM6000A (Part 1) -- Case Management Essentials - An Evidence-based Approach HM6000C (Part 3) -- Case Management Essentials - Key Concepts & Practical Application
PART 2 OF 3 OBJECTIVES Explain the relationship between Utilization Review/Management and Case Management. Describe the use of criteria/guidelines in the utilization management process. Explain the primary responsibilities of the case manager when documenting from a UM perspective. Explain the four modalities which are the most commonly used UM tools at this time: length of stay (LOS), InterQual, clinical pathways, and Milliman Care Guidelines (MCGs). Discuss The Joint Commissions standards and Medicare's Conditions of Participation as they apply to hospitals and the discharge planning process. Explain the 'Important Message' from Medicare and the four Hospital Issued Notices of Noncoverage. Define and explain what constitutes skilled, non-skilled, subacute, intermediate, and custodial levels of care. Describe each stage of the case management process. List the criteria that qualify a patient for case management services. Describe the primary strategies that ensure effective assessment and implementation and monitoring of the case management plan of care. TABLE OF CONTENTS CASE MANAGEMENT PROCESSES AND ACTIVITIES Chapter #4. Utilization Management Chapter #5. Transitional Planning: Understanding Levels of Care and Trasitions of Care Chapter #6. Case Management Process