Case Management Essentials

Great First Step Into Case Management
This program is a great first step towards a new career in Case Management. Upon completion of all 3 parts of this program you will receive a Certificate of Achievement that can be submitted along with your resume for entry level Case Management jobs. This Certificate of Achievement confirms your successful completion of a comprehensive introductory program in Case Management. You will be able to talk intelligently with hiring authorities about the basics of case management and you will be better prepared and more confident when applying for entry level positions. Case Management Essentials builds an excellent foundation of knowledge for individuals wanting to explore a career in case management.

HM6000A - Part 1 (16 Hours)
  • Overview of Case Management
  • Essential Case Management Job Responsibilities and Skills
  • Reimbursement Concepts
  • View Detailed Curriculum
Test and Textbook: $191.99   $126.99
Test Only: $128.00   $63.00
HM6000B - Part 2 (18 Hours)
  • Utilization Management
  • Transitional Planning: Understanding Levels of Care and Transitions of Care
  • Case Management Process
  • View Detailed Curriculum
Test and Textbook: $207.99   $142.99
Test Only: $144.00   $79.00
HM6000C - Part 3 (22 Hours)
  • Key Concepts in Case Management
    • Quality Management and Outcomes
    • Legal Issues in Case Management
    • Ethical Issues in Case Management
  • Practical Applications
    • Case Management Credentials, Organizations and Standards
    • Job Stress and Success Factors in Case Management Practice
  • View Detailed Curriculum
Test and Textbook: $239.99   $174.99
Test Only: $176.00   $111.00


Case Management Essentials
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Course Curriculum:

HM6000A - Part 1 (16 Contact Hours)
  • Overview of Case Management
    • Define case management
    • State the difference between case management and managed care
    • List 4 milestones in the history and evolution of case management systems
    • Name 5 models of case management
    • Describe the role of the nurse versus the social worker in case management
    • Recognize 5 strategies in ensuring the effectiveness of case management models
    • Determine the value of tele-health and information systems in the practice of case management
  • Essential Case Management Job Responsibilities and Skills
    • Explain 5 optimal and 5 undesired outcomes of case management
    • Describe the roles and responsibilities of case managers
    • Differentiate between a case manager's leadership roles and personality traits
    • Describe 3 approaches to training and education of case managers
    • List the various necessary topics to be covered in a case management education program
  • Reimbursement Concepts
    • Describe the various methods of reimbursement for health care services
    • Define prospective payment system
    • Define managed care organizations
    • Differentiate between governmental and private (commercial) insurance
    • Differentiate between Medicare and Medicaid benefit programs
    • Determine the role of case managers in managed care contracting
    • List 5 reimbursement-related responsibilities of case managers


HM6000B - Part 2 (18 Contact Hours)
  • Utilization Management
    • Define the terms utilization review and utilization management
    • Describe the use of criteria and guidelines in the utilization management and review process
    • Differentiate between the various types of reviews
    • Determine the role of the case manager in utilization management
    • Recognize the impact of documentation on utilization management
    • List 5 characteristics of case management plans
  • Transitional Planning: Understanding Levels and Transitions of Care
    • Define the terms discharge planning, transitions of care and levels of care
    • Discuss the relationships between transitions of care and levels of care
    • Differentiate between the various care settings across the healthcare continuum
    • Differentiate skilled from non-skilled care
    • Explain the relationships among transitional planning, utilization management and reimbursement
    • Describe the role of the case manager in the various practice settings
    • Report the impact of case management on care quality and patient safety during transitions of care
  • The Case Management Process
    • Describe each stage of the case management process
    • List 5 criteria that qualify a patient for case management services
    • Determine the essential components of a case management assessment
    • Develop a case management plan of care, including establishing goals and prioritization of needs
    • Describe 4 strategies that ensure effective implementation of the case management plan of care
    • Recognize the importance of ongoing monitoring and evaluation of the case management plan of care
    • Identify 3 strategies for effective closure of case management services


HM6000C - Part 3 (22 Contact Hours)
  • Quality Management and Outcomes
    • Define performance management, outcomes management, risk management and core measures
    • Describe the relationship between case management and quality management
    • Describe the process of quality reviews
    • Explain the role of the case manager in quality and outcomes management
    • List 5 strategies in case management practice that enhance patient safety
    • Describe the role of the case manager in the reporting of outcomes (core measures)
  • Legal Issues in Case Management
    • Distinguish negligence from malpractice
    • Recognize the importance of documentation in avoiding risk for litigation
    • List 4 strategies to ensure appropriate patient's discharge or case closure
    • Describe the informed consent process
    • Explain the role of advance directives in the planning and case management of patient's care
    • Identify 5 strategies case managers may use to reduce legal risk
  • Ethical Issues in Case Management
    • Describe the process of ethical decision making
    • Recognize ethical dilemmas in case management practice
    • List 4 ethical principles important to case management practice
    • Differentiate between clinical and organizational ethics
    • Identify 5 strategies for the effective management of ethical dilemmas
  • The Case Management Credentials, Organizations, and Standards
    • Identify professional organizations or societies that are important to case management
    • Describe accreditation and accreditation agencies affecting case management responsibilities and processes
    • Identify the various case management credentials and certifications
    • List the eligibility criteria and examination content for organizations and agencies that provide case management certifications and credentials
    • Describe case management standards, guidelines and protocols
    • Define accreditation
  • Job Stress and Success Factors in Case Management Practice
    • List 3 strategies for avoiding role conflict
    • Describe the 5 steps of problem solving
    • Recognize subtle approaches to effective time management
    • Explain the importance of self-care
    • Illustrate 5 strategies for effective communication
    • Recommend 4 techniques for enhancing emotional intelligence skills
    • Name 3 effective approaches to multi-disciplinary collaboration