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Professional Certificate in Medical Case Management

Professional Certificate in Medical Case Management

Course schedule subject to change

In-Person

Online

H Hybrid

Required (12.5 units)
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Winter

Spring

Summer

Fall

Effective Case Management: Connecting to Healthcare Systems

This course examines the principles of managing client services and support needs while maintaining fiscal viability. The Case Management Society of America's Standards of Practice are the basis for discussing aspects of successful case management. Explore case management processes in a variety of settings such as acute hospital and managed care, worker compensation and disability, and community-based case management. Also discussed are the types of insurance related to the CM process, community-based organizations and agencies, and alternative services. Designed for those currently in or seeking to enter the field of case management including registered nurses, nurse practitioners, physicians, social workers, counselors and others interested in case management.

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2 units

Effective Case Management: Connecting to the Community

Fundamental principles and mechanics of effective case management. Various models of case management, the process and functions of case management, and the historical context of case management are discussed. Topics include historical origins of and recent developments in case management, removing barriers through interagency and interprofessional collaboration, service monitoring and evaluation, resource mobilization, technical assistance, and case consultation. Interpersonal skills are developed through the use of practice exercises and roleplays.

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2 units

Utilization Review and Quality Management in Health Services

As providers face increased pressure to reduce costs, they have found it essential to implement comprehensive utilization management programs. Successfully used tactics such as case manager teams, clinical pathways and physician-staffed utilization review committees to manage patient care under capitation to ensure proper resource utilization are examined. This course explores promotion of physician involvement and negotiating the transition to capitation successfully.

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2 units

Medical Ethics

Impact of ethics on clinical decision making, treatment choices and a patient's clinical outcome; the effective tools to help manage a variety of clinical situations, conflicts and cases; and life-and-death issues now being encountered in the increasingly complex health care system.

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2 units

Hospital-Based Case Management

Explores the role of and tasks performed by the nurse case managers based in acute hospitals. The course provides participants with an understanding of concurrent utilization review, including use of criteria, documentation and communications. Additional topics include discharge planning processes such as discharge screening and assessment. Hospital case management issues and concepts examined include critical paths, differentiating case management from care management, handling denials, continuity of care, alternative resources and financial considerations.

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1.5 units

Financial Coverage and Benefits Systems in Case Management

Case managers promote quality and efficiency, while tracking outcomes that include both clinical and financial objectives. In this course, you will learn about coordination of benefits, reimbursement for health care services, workers compensation and other forms of coverage, and negotiation for services on behalf of your client.

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2 units

Introduction to Life Care Planning (LCP)

A Life Care Plan (LCP) is a dynamic document that provides an organized, concise plan for current and future needs and associated costs for individuals who have experienced a catastrophic injury, or have chronic healthcare needs. This course examines the LCP and its uses and methodology, including: the interview, medical record review, collaboration with treatment team, needs assessment, and report writing. Checklists used in developing LCPs are reviewed. Designed for medical case managers, legal nurse consultants, attorneys, physicians, rehabilitation professionals, and others who provide support to those with catastrophic or chronic illness.

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1 units

Field/Home Health Concentration Electives (2.5 units)
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Winter

Spring

Summer

Fall

Job Analysis by the Field Case Manager

Case managers are often asked to evaluate a patient's readiness to return to work by analyzing the workplace environment and work tasks in relation to the patient's medical condition, injury or disability. This course explores the skills required by the nurse or field case manager to assess a patient's job capability effectively and make recommendations for workplace modifications. This course also identifies the opportunities and resources available to nurses and field case managers to support these activities.

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1.5 units

Medical Case Management in the Field

Prepares the nurse case manager for performing case management activities in the field. Topics include initial interviews with patients and clients in the home or community setting, and the importance of goal-directed planning. Additional discussions include arranging and attending physician appointments, communication and collaboration skills, problem solving, the evaluation of the patient level of engagement, and education needed to promote successful outcomes. The documentation and reporting aspects of field case management, including cost to benefit analysis and billing for services, are examined.

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1.5 units

Aging Population/Geriatric Concentration Electives ( units)
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Winter

Spring

Summer

Fall

Aging and Mental Health

There are a variety of mental health-related clinical disorders that impact the aging population disproportionately.  Issues such as Dementia, Alzheimer’s, Neurocognitive disorders, Parkinson’s disease, and major depressive disorder are all major clinical and health-related conditions. When working with this population, one should be familiar with how these psychological issues can impact global daily functioning. In this course, we will review the basic elements of mental health care for this population, how these conditions impact quality of life, and different treatment modalities.

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1 units

Introduction to Life Span Development

An introduction to the basic elements of life span development in adulthood, the issues specific for each period of development, and how development may impact quality of life. Explore issues specific for each life period such as identity formation, work life, relationship development, procreation, child rearing, retirement, health, disability, and death and dying. Learn how these issues impact individuals in a variety of ways.

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1.5 units

Healthcare Advocacy/Social Services Concentration Electives ( units)
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Winter

Spring

Summer

Fall

Effective Case Management: Connecting to the Client

The development of a helping relationship with clients is strongly influenced by the case manager's projection of attitudes of respect, empathy and cultural sensitivity toward others. This course explores essential case management skills and values as they relate to the various types of clients requiring case management services. These client populations may include the elderly, chronically ill adults and children, those with substance abuse or other mental health disability, veterans and other vulnerable populations.

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2 units

New Opportunities for Healthcare Advocacy

Health care advocates support and promote the rights of the patient to ensure available, safe and quality care. Explore the patient-centered care approach and develop practical skills to improve communications and enhance compliance in managing health and health care benefits. Just what patients need for survival!

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2 units

Substance Abuse/Addictions Concentration Electives ( units)
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Winter

Spring

Summer

Fall

The Substance Abuse Treatment Continuum

A comprehensive approach to behavioral health and substance abuse treatment also means seeing prevention as a part of an overall continuum of care. This model includes promotion, prevention, treatment, and recovery.

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1 units

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