Managed Health Care CE Courses Program

The American Institute of Health Care Professionals, Inc., offers a full Continuing Education program of online courses for health care professionals seeking Certification as a Managed Health Care Consultant.

Upon completion of the four (4) courses detailed below, applicants are eligible to apply for and receive certification as a Certified Managed Health Care Consultant. This program provides for continuing education related to managed health care, finance, quality improvement in health care and population health. The curriculum provides for a comprehensive study of core essentials for professionals to master Managed Health Care Consulting.

Each course is provided for in a dedicated online classroom. The courses are designed as independent study/continuing education courses, with one-to-one faculty mentoring. There is open enrollment and students may register and begin the education program at anytime.

For information on the Managed Health Care Certification program, access this link

Course Fees: Below are listed the required courses for this curriculum. At the end of each course description you will find the course cost listed. All textbooks and learning materials are separate and not included in the course cost.

MANAGED HEALTH CARE CONSULTANT CONTINUING EDUCATION COURSES

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. For additional information please access here. All of the following CE Courses are approved by the California Board of Registered Nursing for the number of contact hours listed for each course as below.

The following CE Courses also have the following Approvals:
The American Institute of Health Care Professionals Inc. is an Approved Provider of Continuing Education by the Florida State Board of Nursing and the District of Columbia 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 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.

HM 540 – Budgeting & Finance for Health Care Managers

This course is designed for health care managers who are not in financial management executive positions. It is particularly designed for first-line supervisors, department directors, operational managers and those in health care who have responsibilities for the management and budgeting of human and supply resources. This course is designed with an emphasis on content for managers with a non-financial background that require a sound understanding of the concepts of health care budgeting and financial management. The course covers a comprehensive amount of material going from introductory and foundational concepts in budgeting and finance, progressing into more intermediate and advanced concepts. Students receive a well-rounded course that will serve them very well in their roles as managers in health care practice.
Important content in this course includes models of budgeting in health care management, cost behavior and analysis, health care reimbursement methodologies, capital budgets, cash budgets, understanding financial statements, presenting budget and financial data, clinical quality improvement and financial outcomes, financial planning, health care business models, challenges to financial success, and the role of government in financial management of health care organizations.

Course Code: HM 540. Contact hours of Continuing Education = 45. Course Cost = $ 150.00

HM 550 – Insurance, Reimbursements & Managed Health Care

This online CE course is a comprehensive course in Managed Care, as well as the Insurance Industry in general. Students will examine a comprehensive and foundational overview of the history of health insurance and in particular Managed Care. The text book used is most current and up to date and provides students with the latest policies and changes regarding health care insurance/benefits as well as political processes that have affected such changes in the marketplace. The content in this course moves from intermediate level content to move advanced content and concepts as the student progresses. Including in the learning in this course is comprehensive content on health benefit plans and the various types of health plans and payers today. Students will learn all about risk and risk-sharing and risk contracts in managed care. Provider networks are presented, how they are structured, how they work and what outcomes are being seen with such structures in place. Students will study comprehensive content on provider payment structures, including cost sharing methodologies, risk-based vs. non-risk based payment structures, value based payment, and many others.
Learning moves on to Utilization Management concepts and methods and how these are incorporated into the overall insurance health plans and managed care plans today, as well as the role of case managers in utilization management. Principles of Quality Management are explored. Students will also examine and learn about insurance and managed care health plan and organizational accreditations, certifications and award programs. Included in the course content is the administrative practices related to health insurance and managed care plans and organizations where students will learn about analytics and informatics, sales, actuarial services, eligibility issues, claims, benefits, fraud and abuse issues, and management challenges. There is a significant study of Medicare and Medicaid including Medicare Advantage where students examine and learn all about these governmental benefit plans, how they work and what they mean for health care organizations, providers and for patients. Students will also study issues related to laws and regulations in health insurance and managed care. This course is also approved by the Florida Board of Nursing for 30 contact hours of continuing education, The American Institute of Health Care Professionals, Inc. is an Approved Provider of Continuing Education by the Florida State Board of Nursing, Provider # 50-11975.

Course Code: HM 550. Continuing Education Contact Hours = 50. Course Cost = $ 175.00

HM 560 – Principles of Health Care Quality Improvement and Management

This CE course is designed for the working supervisors, assistant managers and department managers and for those who aspire to hold these positions in their healthcare organization. In addition, Nurses practicing in the Legal field and as Cases Managers can benefit from this course. We recognize that managers with a non-quality background also need a sound understanding of the concepts of health care quality management and measurement. Understanding quality processes is paramount to managing your department so your organization can provide optimal care to your patients. Our goal is to provide a foundation, with sufficient guidance, and enough information about Quality management, in the context of health care, for both prospective and sitting managers to be successful in the daily running of their departments and understand how to measure their performance. An understanding of quality tools and methodology will prepare students to select appropriate performance standards in the environments they work in.

Course Code: HM 560. Contact hours of Continuing Education: 30, Course Cost: $150

CM 585 – Population Health: Building a Foundation for Wellness

This CE course focuses on the major components of Population Health, past and present. You will review interesting complex systems and discover how a culture of wellness is created. We review organizations response to managing patients through Population health initiatives. Population Health data and analytics are discussed as are reimbursement models to support value-based care. The importance of Health Information systems impact on population health measurements of success from an epidemiology perspective are reviewed. Accountability for outcomes and quality is also an important part of the core material for this course as are disease prevention initiatives and access to care. Health promotion and consumer engagement models are also explained in relation to the social determinants of health. Population Health payment and patient management models are also reviewed. Key Population Health Stakeholders are identified. The future of population Health is projected with the establishment of the desired culture needed to be successful as well. The role of change management methods employed to make Population Health successful is also part of our studies. We also look at the many influences of policy setting practices that happen in the U.S healthcare system and legislation that affects Population Health programs. This course will expose any prospective or sitting manager to the many contemporary issues they need to be conversant with in order to be successful in their jobs.

Course Code: CM 585. Contact hours of Continuing Education: 45, Course Cost: $175

ADDITIONAL INFORMATION:

Pre-requisite to enrolling in the continuing education program and qualifying for Managed Health Care Consultant Certification:
Registrants must meet at least one of the following:
- A registered nurse currently licensed to practice nursing
- A licensed social worker
- A licensed counselor
- A licensed psychologist
- A licensed physician
- A health care licensed professional
- A health care provider with a minimum of an associate degree, and must have job experience in managed care or case management
- Hold a bachelor’s degree or higher in psychology, human services, or other health related field and must have job experience in managed health care or case management
- A health care executive, director or health care manager
- A licensed and experienced insurance professional will be evaluated on an individual basis for entry after evaluating qualifications.
If you would like to find out if you meet the qualifications for this fellowship program. Please submit an Inquiry Form at the following link: Access Inquiry Form Here.
All courses are continuing education courses and are provided in online classrooms via our website. Upon enrollment a unique identification and password is provided for classroom access. The online classrooms provide full syllabi and course information, including the course exams and evaluations. Students must achieve a minimum score of 70% on the course examination to pass the continuing education courses.
Participants are given two (2) years from the date of enrollment into the first course, to complete the entire program of four (4) continuing education courses.
Upon completion of each course, you will be awarded the corresponding continuing education contact hours and receive the CEU certificate verifying course completion and the award of education credits. Registration may be completed online, by accessing the links below.