Course Information

This course is part I of an advanced course in case management with a comprehensive focus of study on the roles and the applications of professional Case Manager practice. Throughout this course students will examine in-depth information related to the many roles of the professional Case Manager and how they integrate their roles into many different models of case management practice today. Emphasis is on examining models of professional case management with Case Manager Applications of practice including theory and process. Students will be able to comprehend not only the role of the Case Manager but also the applications of professional practice in a wide variety of care settings. Students will examine key learning concepts such as the case manager as problem solver and educator, standards of case management, the case management work format and process, and the dynamics of communications and patient engagement. There is an extensive examination of the many practice settings and models of care in which professional case managers are practicing today where the role and applications of practice are detailed. Studies with also study other diverse models of case management including independent case management, home care case management and long-term care case management, as well as pediatric case management and worker’s compensation case management. Legal and ethical issues and responsibilities of professional case managers are presented and examined as well in this course. Other topics presented in this first part of the advanced case management course include evidence-based practice for case managers and data-drive decision making. Following successful completion of this course, students may register for part II of this course CM 565. Course Code: CM 545. Contact hours of education = 35. 

Level of Complexity: Advanced

Pre-requisites: This course is particularly designed for those who would like to apply for Fellowship certification as a “Fellow” in the American Academy of Case Management. Pre-requisite to enter this course: must be an RN, Physician, Social Worker, Behavioral Health Specialist, or employed currently as a Case Manager or Utilization Review Specialist in a health care setting. Others may be granted access after individual review and consideration by the Administration of the American Academy of Case Management.

Course Refund & AIHCP Policies: access here

Instructor/Course Author: Dominick L. Flarey, Ph.D, MBA, RN-BC, ANP-BC, FACHE

Link to Resume: access here

Email: info@aihcp.org

BOARD APPROVALS: The American Institute of Health Care Professionals, Inc. is a licensed Continuing Education Provider in the State of California, Board of Registered Nursing, Provider # CEP 15595. This course is approved for 35 contact hours of continuing education by the California Board of Registered Nursing. Access information

This course, which is approved by the Florida State Board Of Nursing (CE Provider # 50-11975) also has the following Board of Nursing Approvals, for 35 contact hours of CE:
The American Institute of Health Care Professionals Inc: is a Rule Approved Provider of Continuing Education by the Arkansas Board of Nursing. CE Provider # 50-11975.
The American Institute of Health Care Professionals Inc: is a Rule Approved Provider of Continuing Education by the Georgia Board of Nursing. CE Provider # 50-11975.
The American Institute of Health Care Professionals Inc: is a Rule Approved Provider of Continuing Education by the South Carolina Board of Nursing. CE Provider # 50-11975.
The American Institute of Health Care Professionals Inc: is a Rule Approved Provider of Continuing Education by the West Virginia Board of Examiners for Professional Registered Nurses. CE Provider # 50-11975.
The American Institute of Health Care Professionals Inc: is a Rule Approved Provider of Continuing Education by the New Mexico Board of Nursing. CE Provider # 50-11975.

TEXTBOOK: There is one required Textbook for this course.

The Case Manager’s Handbook, 6th Edition. By: Catherine M. Mullahy. Jones & Bartlett Learning. New York: 2017. ISBN#: 9781284102406.

Link to Purchase on Amazon.com: click here

GRADING: You must achieve a passing score of at least 70% to complete this course and receive the 35 hours of awarded continuing education credit. There are no letter grades assigned. You will receive notice of your total % score. Those who score below the minimum of 70% will be contacted by the American Institute of Health Care Professionals and options for completing additional course work to achieve a passing score, will be presented.

TIME FRAME: You are permitted two years from the date of enrollment, to complete this course. There are no other set time-frames, other than the two year allotted time. If you do not complete the courses within the two-year time-frame, you will be removed from the course and an “incomplete” will be recorded for you in our records. Also, if you would like to complete the courses after this two-year expiration time, you would need to register and pay the course tuition fee again.

COURSE OBJECTIVES: 

Upon completion of this course, you will be able to:

1. Discuss the role of the case manager in today’s health care practice environment
2. Compare and contrast case management and managed care
3. Provide a definition of case management
4. Define and discuss the various roles and functions of case management
5. Define and discuss certification, accreditation and standards of practice
6. Discuss and understand that proliferation of new titles encroaching on the case manager’s role
7. Discuss the role of the case manager as a key health care provider
8. Define and discuss the domains of knowledge of the professional case manager
9. Discuss the screening process in case management
10. Define and discuss stratifying risk in the case management process
11. Discuss the planning process in case management
12. Discuss implementing care coordination in the case management process
13. Discuss following-up, transition and evaluating in the case management process
14. Discussion and understand issues related to referral sources in the case management process
15. Discuss and understand the important of communication strategies of the role of the case manager with patients, families, other providers, and physicians
16. Define and discuss the concept of telephonic case management
17. Discuss proper procedures for obtaining approvals in the case management process
18. Define and discuss process and procedures for implementing care coordination
19. Define patient engagement
20. Discuss shared decision making
21. Discuss communications within new models of care
22. Define and discuss the challenges and the strategies case managers can use in communicating with physicians
23. Define and discuss the Burn-Out red flags for case managers
24. Define and discuss ACO’s, PCHMs, and State Health Exchanges
25. Define and discuss the role of the case manager in independent case management practice
26. Discuss the development of a business plan for independent case management practice
27. Discuss how to develop a business model and market a business as an independent case manager
28. Discuss the role of the case manager in home care case management
29. Discuss the role of the case manager in long-term care case management
30. Review and discuss cases related to the role of the case manager in home care and long-term care case management
31. Discuss negotiations for long-term care case management
32. Define and discuss the implications for long-term care for the family and the case manager
33. Discuss the primary challenges facing pediatric case managers
34. Understand quality improvements in pediatric case management
35. Define and discuss the levels of pediatric case management
36. Discuss the role of the case manager in immunization therapies in pediatric case management
37. Understand and discuss the care of children with mental health issues
38. Define and discuss the benefits of case management in pediatric case management
39. Discuss benefits issues to workers in workers compensation cases
40. Define and discuss the role of the case manager in workers compensation case management
41. Define and discuss the role of the case manager in Rehabilitation Management collaboration
42. Discuss the impact on the ACA on workers compensation laws
43. Understand the process of mediation in workers compensation claims
44. Define and discuss the key issues for case managers in workers compensation case management
45. Define and discuss the key legal responsibilities of the professional case manager
46. Discuss the Patient’s Bill of Rights and Patient Confidentiality in relation to the role of the case manager
47. Define and discuss the legal issues in case management related to the patient’s medical record
48. Discuss legal issues for case managers related to contracts and letters of agreement
49. Define and discuss U.S. Legislation related to case management
50. Define and discuss the ethical responsibilities of the professional case manager
51. Define and discuss the key issues related to patient’s rights and case manager responsibilities
52. Discuss evidence-based practice as it relates to the role of the case manager
53. Define specific evidence-based resources for case managers
54. Discuss how to apply evidence-based case management practice
55. Discuss key issues related to case manager credentialing and organizational accreditation

COURSE CONTENT

• The case manager as problem solver
• The case manager as catalyst
• The case manager as educator
• Case management vs. managed care
• Case manager credentials and expertise
• Definition of case management
• Case management role and functions
• Certification, Accreditation, and Standards of Practice
• New titles for the case manager’s role
• Health care providers and managed care models
• The case management work format and process
• CCM domains of knowledge
• Case management screening
• Case management stratifying risk
• Implementing care coordination
• Follow-up, transitioning and evaluation
• Referral sources
• Effective communications
• Telephonic case management
• Obtaining approvals
• Implementing care coordination
• Transitioning care
• Communication and patient engagement
• Motivational interviewing
• Communications within new models of care
• Challenges and strategies with physician communications
• Burn-out red flags for case managers
• Hospital case management
• Accountable Care Organizations
• Patient-Centered Medical Homes
• State Health Exchanges
• Independent Case Management
• Home Care Case Management
• Pediatric Case Management
• Worker’s Compensation Case Management
• Legal responsibilities of the case manager
• Malpractice issues
• Patient’s Bill of Rights
• Patient confidentiality
• Medical records legal issues
• Disclosure issues
• Contracts and letters of agreement
• U.S. Legislation in case management
• Ethical responsibilities of the case management professional
• Evidence-based practice for case managers
• Case manager credentialing
• Case management organizational accreditation