Care Coordination and Case Management: An Introduction
Hours: 1.00
The healthcare system is becoming increasingly complex. Therefore, care coordination and case management (CM) are integral to producing optimal member outcomes, decreasing the cost of care, and ensuring effective use of healthcare services. In this course, you will learn about the function, need, goals, and principles of care coordination and CM within the payor setting as well as common challenges that may be encountered. Finally, you will learn about the care coordination and CM process and the benefits to providers, members, and payer organizations.
The goal of this course is to equip nurses and CM professionals with education about the functions and benefits of the care coordination and CM process.
The healthcare system is becoming increasingly complex. Therefore, care coordination and case management (CM) are integral to producing optimal member outcomes, decreasing the cost of care, and ensuring effective use of healthcare services. In this course, you will learn about the function, need, goals, and principles of care coordination and CM within the payor setting as well as common challenges that may be encountered. Finally, you will learn about the care coordination and CM process and the benefits to providers, members, and payer organizations. The goal of this course is to equip nurses and CM professionals with education about the functions and benefits of the care coordination and CM process.
Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling
Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling (CEBroker Provider #50-290)
This activity is approved for 1.00 contact hours.
Ohio Social Worker Board
Ohio Counselor, Social Worker and Marriage and Family Therapist Board (CEBroker Provider # 50-290)
This activity is approved for 1.00 contact hours.
Association of Social Work Boards
As a Jointly Accredited Organization, Relias LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Relias LLC maintains responsibility for this course. Social workers completing this course receive 1.00 General continuing education credits.
Course Delivery Format: Asynchronous Distance Learning-interaction includes quizzes with questions and answers, post-tests. This module is Reading-Based Online.
New York State Education Department, Office of the Professions, Division of Professional Licensing Services, Social Work Unit
Relias, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0009.
Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of licensed master social work and licensed clinical social work in New York. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice for an LMSW and LCSW. A licensee who practices beyond the authorized scope of practice could be charged with unprofessional conduct under the Education Law and Regents Rules.
As a provider of online, asynchronous education, some courses offered by Relias Learning are considered “self-study” under section 74.10(c)(2)(ii)(b)(4) of the Commissioner’s Regulations. The regulations limit self-study activities taken from a provider approved by the Education Department to no more than 12 hours in the 36-month registration period or one-third of the hours in a registration period other than 36 months.
Social workers will receive 1.00 continuing education hours for participating in this course. This activity is approved for 1.00 contact hours.
South Carolina Board of Social Work Examiners
South Carolina Board of Social Work Examiners (CEBroker Provider 50-290)
West Virginia Board of Social Work
West Virginia Board of Social Work (CEBroker Provider #50-290)
California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, CEP# 13791
Nurses will receive 1.00 contact hours for participating in this course.
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Nursing
Florida Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Nurses will receive 1.00 Nursing Contact Hours after successfully completing this course.
Georgia Board of Nursing
Georgia Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
South Carolina Board of Nursing
South Carolina Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
West Virginia Board of Registered Nursing
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Board of Nursing
New Mexico Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Arkansas State Board of Nursing
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Kentucky Board of Nursing
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Mississippi Board of Nursing
Mississippi Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
North Dakota Board of Nursing
North Dakota Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Commission for Case Manager Certification
This program has been pre-approved by The Commission for Case Manager Certification to provide 1.0000 hours of continuing education credit to CCM® board certified case managers.
Summarize two key functions and benefits of care coordination and case management in the payer setting.
Describe how effective care coordination and case management surpass clinical perspectives to facilitate more encompassing healthcare improvement.
Describe two key components involved in the care coordination and case management process.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: General Concepts
Care Fragmentation
Fragmentation Examples
Impact of Fragmentation
Definitions
Care Coordination
Case Management
Disease Management
Benefits of CM
CM Principles
Case Manager Responsibilities
The Role of CM
Goals of CM
Knowledge Domains
Gaps in Care
Bridging the Gaps
Review
Summary
Section 3: The Case Management Process
Process Overview
Identification
Methods for Identification
Screening
Cyclical Process
Step 1: Assessment
Data Discovery
Member Engagement and Interview
Findings Report
Step 2: Planning
Step 3: Implementation and Care Coordination
Step 4: Follow-Up
Step 5:Transitions of Care
Transitional Care Functions
Step 6: Evaluation and Measurement
Review
Summary
Section 4: Conclusion
Course Summary
Course Contributor
Resources
References
Exam and BrainSparks
Cathryn Ayers, RN, MSN has nearly 10 years of critical care experience. She was active in multiple committees to improve patient safety, executed staff education activities, and managed the new graduate orientation program for those entering intensive care units. Cathryn obtained a license for massage and bodywork therapy in 2012 and graduated from the University of North Carolina at Greensboro in 2016 with a Master of Science in Nursing Education. She has provided telephonic case management services and developed program materials to facilitate positive outcomes for people with rare conditions across the United States. Cathryn has a passion for teaching and helping others to be their best. Disclosure: Cathryn Ayers, RN has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.
The target audience for this course is: Case Managers; Nurses; Social Workers; in the following settings: Acute Care Facility.
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.
