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Case Management Certification Review Course
This program is designed to: *Provide a Study Guide for those preparing for National Certification *Share Insights into the practice for those new to Case Management.
Module 1 Session 1: Current Trends in Healthcare
This unit discusses the current trends in healthcare including the challenges, system changes, and opportunities for case managers.
Unit 1 Current Trends in Healthcare
Module 2 Session 2: History of Case Management
In this unit you will learn about the history of the practice of case management as well as the basic concepts, goals and essential functions of case management. You will also learn important information about the CCM exam.
Unit 1 History of Case Management
Module 3 Session 3: CM Competencies and Responsibilities
After reviewing this unit you will understand the essential CM competencies, roles case managers play, different settings case managers practice, and case management modules. You will also have a better understanding of the care coordination team and how they work together.
Unit 1 CM Competencies and Responsibilities
Module 4 Session 4: Rehabilitation, Workers Compensation and Disability Management
In this unit you will learn what rehabilitation is, the goals of rehabilitation, and the types of rehabilitation available. You will also learn about workers compensation including the goals of workers compensation case management and the key people in workers compensation cases. You will learn the return to work process and strategies used to return an injured worker to gainful employment. This unit also discusses the vocational aspects of chronic illness and disability, disability insurance, and life care planning.
Unit 1 Rehabilitation, Workers Compensation and Disability Management
Module 5 Session 5: Data Management
After completing this unit you will understand the important role data management plays in healthcare today. This unit discusses the history, key attributes and critical components of Health Information Technology (HIT). You will also learn about Meaningful Use, Evidence Based Medicine, and Comparative Effectiveness.
Unit 1 Data Management
Module 6 Session 6: Resource Management
Resource Management is one of the core functions of case management. In this unit we will discuss the types of resources available, who pays for them, and nontraditional sources of resources.
Unit 1 Resource Management
Module 7 Session 7: Utilization Management
After completing this unit you will be able to differentiate between utilization review and utilization management, understand the goal of utilization management, be aware of changes in reimbursement methods including value based purchasing, and understand the authorization, denial and appeals process.
Unit 1 Utilization Management
Module 8 Session 8: Population Health and Disease Management
After completing this unit you will understand: *What population health and disease management are *The need for population health and disease management *The impact disease has on healthcare costs *Risk stratification and screening tools used in population health and disease management *The importance of patient engagement in population health and disease management *Motivational interviewing *The most common and catastrophic disease states *Trends in population health and disease management
Unit 1 Population Health and Disease Management
Module 9 Session 9: Healthcare Legislation
This unit discusses how health policies impact CM and reviews specific legislation important to case managers such as The Rehabilitation Act of 1973, The Emergency Medical Treatment and Labor Act (EMTALA), Health Insurance Portability & Accountability Act (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), American with Disability Act, Family Medical Leave Act 1993, Longshore & Harbor WC Act 1927.
Unit 1 Healthcare Legislation
Module 10 Session 10: Reimbursement Systems
After reviewing this unit you will be aware of the different healthcare reimbursement systems available and the difference between them. You will also be aware of the essential points of reimbursement and terms related to reimbursement systems.
Unit 1 Reimbursement Systems
Module 11 Session 11: Legal and Ethical Issues Impacting Case Management
This unit explains the importance of following the Case Management Standards of Practice, as well as legal responsibilities in case management. It also discusses ethical issues and principles, delegation of care, patient confidentiality and security, conflict of interest, informed consent and malpractice.
Unit 1 Legal and Ethical Issues Impacting Case Management
Module 12 Bonus Material and CNE Credit Info
Supplemental material to assist you in your studies.
Unit 1 Test Taking Strategies for the CCM Exam
Unit 2 Frequently Asked Questions (FAQ)
Unit 3 CNE Credit

 

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