Health & Human Services, Enrichment, and Business and Management Enrichment Health and Human Services Business & Management

Certificate Program in Case Management

Reducing costs and improving quality of care are the hallmarks of the health care delivery model known as case management. This certificate program provides a comprehensive discussion of components of case management in any health care setting and promotes the development of case management best practices. Case studies will illustrate the material discussed each day. In this certificate program, participants will:

  • Explore the integrated case manager role, including managing care, discharge planning, utilization and customer service
  • Develop data management reports that reflect the outcomes of your case management practice
  • Apply various patient/payer reimbursement structures that will assist in acquiring optimal financial outcomes
  • Discuss regulatory agency requirements that affect a case manager's practice
  • Review and develop critical pathways for both generic and specialty based practice
  • Apply "real" case management strategies to your practice

The instructor provides career counseling related to case management and the program is beneficial in preparing for the case management certification exam.

Day One: Case Management Basic Elements

  • History and role of the case manager
  • Multidisciplinary collaborative practice
  • The physician as advocate
  • Length of stay and extended stay management
  • A career in case management

Day Two: Outcomes Management: Critical Thinking and Critical Pathway Development

  • Critical thinking concepts for everyday practice
  • Description, development, and critical pathway implementation strategies
  • Variance/exception analysis
  • Alternatives to using a critical pathway

Day Three: Discharge Planning: Role and Departmental Integration

  • Integration and other models
  • Levels of care
  • Referral service
  • Process of discharge
  • Outcomes

Day four: Utilization Management

  • Payers
  • Reimbursement systems
  • Utilization process
  • Building relationships with payers
  • Working toward zero denial rate

June Stark, R.N., B.S.N., M.Ed., is director of case management, quality support services at Tufts Medical Center in Boston, and an associate consultant for The Center of Case Management in Natick, Massachusetts.


4 Fridays, September 27-December 13, 9:30 a.m.-3:30 p.m.

Registration has ended. Please browse courses for future offerings of this course.

$625 (24 contact hours/ 2.4 CEUs)
Abromson Center, 88 Bedford Street, USM Portland campus

 

Class meets 9/27, 11/1, 11/15, and 12/13.