Certified Case Manager
Principles of Case Management Practice Target Populations Case finding and intake Provision of services Evaluation and Case closure Utilization Management Psychosocial & economic issues focus on pt and family, negotiating, procuring and coordinating services and resources, use of clinical reasoning, development of various relationships, episode or continuum based diagnosis, high utilizers, age & health status, procedure, LOS, psychological factors, vocational, functional impair- ments, disability ID member, obtain consent, communi- cating member needs to others, ID mem- bers who need alternate levels of care facilitate and coordinate, communicate with other healthcare providers, monitor progress, review and modify healthcare services, collaborate with stakeholders on CM plan, advocate for pt and family, assure adherence to various standards collect, analyze and report data, evaluate quality of services, ensure access to ser- vices, apply evidence based practices, close relationship when appropriate, re- port termination to stakeholders, education pt re illness prevention evaluate appropriate level of care, com- municate with payers and healthcare providers, allocate resources, manage appeals and denials, review pt condition for appropriateness of hospitalization, ID cases that are at risk for complication
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- Uploaded on
- September 6, 2023
- Number of pages
- 14
- Written in
- 2023/2024
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- Exam (elaborations)
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- Questions & answers
