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Case Manager's Training Manual

Author(s): David Plocher, MD
Patricia Metzger, MHA, RN
Details:
  • ISBN-13: 9780834219304
  • ISBN-10:0834219301
  • Hardcover    318 pages      © 2001
Price: International Sales $133.95 US List
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Overview

The health care industry has a need for well-trained case managers. However, too often nurses are recruited or promoted to case manager with little or no formal training and without the necessary resources to support them. The Case Manager's Training Manual outlines the essential policies and procedures hospital-based case managers need in order to effectively do their jobs. It covers such subjects as: * Roles and responsibilities * Staffing ratios * Job descriptions * Medicare/Medicaid and managed care * Utilization management * Legal issues * Discharge planning * Community-based case management.

This one-of-a-kind reference links clinical case management and payer-based case management. New case managers will find it to be a valuable resource to help them prepare for and excel at this complex and demanding profession.

ShowTable of Contents

THE FUNDAMENTALS * Organizational Structure of Case Management Programs * Recruiting Case Managers * What Every Case Manager Should Know about Managed Care * Understanding Utilization Management * Understanding Chart Review * Denial Management and Related Care Coordination * Physician Partnering and the Case Manager's Role in Conflict Mediation * Patient's Rights and Effective Communication Techniques * Regulator Impact on Daily Work Flow * Contents: DOCUMENTATION AND MEASUREMENT * The Role of the Case Manager in Hospital Preparation for Joint Commission Accreditation * The Case Manager as a Facilitator of Accurate Medical Record Documentation * TRANSITION FROM DISCHARGE PLANNING TO COMMUNITY-BASED CASE MANAGEMENT * Transition Planning (Discharge Planning) * Postacute Services * Home Health Care * Hospice and End-of-Life Care * Community-Based Case Management * Communications between the Hospital-Based Case Manager and the Payer * INFORMATION TECHNOLOGY SUPPORT FOR CASE MANAGERS * The Case Manager's Guide to Hospital Cost Accounting Systems * Decision Support for Case Managers * MODELS FROM MEDICAL CENTERS REDESIGNING CASE MANAGEMENT * Rapid Design * Improving the Care of Complex Populations: A Case Study in Clinical Redesign of Patients with Acute Myocardial Infarction * Improving the Care of Complex Populations: A Case Study in Clinical Redesign on Extremely Immature Neonates * Improving the Care of Complex Populations: A Case Study in Clinical Redesign on a Trauma Service * Glossary * Index
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ShowAbout the Author(s)

David Plocher, MD

Patricia Metzger, MHA, RN

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