A Guide for Nurse Case Managers

A Guide for Nurse Case Managers Author Charlotte Cox
ISBN-10 9781450238564
Release 2010-08-12
Pages 92
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The position of nurse case managers can be a rewarding but challenging career, as these managers play a vital role in a patient’s care. In A Guide for Nurse Case Managers, author Charlotte Cox provides an insightful guide to this evolving field of medicine. Geared for those working in hospital settings, clinics, and health plan offices, this helpful reference text provides guidelines, tips, and tools for becoming a successful nurse case manager. With more than thirty years of health care experience, Cox provides a detailed overview of this important nursing position that works to usher a patient through the health care system. A Guide for Nurse Case Managers • defines the case manager role; • provides an understanding of the basics of utilization and case management; • gives an overview of Medicare and Medicaid procedures; • discusses the care planning process; • shows how to structure a community resource base. Whether you are a new case manager, a student, or a seasoned nurse needing a refresher about job basics, A Guide for Nurse Case Managers will help to shape your practice, provide valuable tips and reference tools, and help you with proven organizational ideas to succeed in the career.



Case Management

Case Management Author Suzanne K. Powell
ISBN-10 078171883X
Release 2000
Pages 522
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The Second Edition of this comprehensive "how to" text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies.



Nursing Case Management

Nursing Case Management Author Elaine Liebman Cohen
ISBN-10 0323027652
Release 2005
Pages 620
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Review: "This practical resource, written by foremost experts in the field of case management, features complete coverage of every aspect of nursing case management, from its evolution and history to the latest case management models." "The new, fourth edition has been completely updated and is designed to help you prepare, implement, and evaluate a case management program within the framework of today's health care environment."--BOOK JACKET



Disease Management

Disease Management Author Diane Huber
ISBN-10 0721639119
Release 2005
Pages 287
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Written specifically for case managers, this innovative reference presents a practical integration of disease management and case management to ensure comprehensive coverage of these two rapidly evolving and expanding fields. It explains and clarifies these two areas with in-depth expert commentary that offers a fresh, contemporary approach and captures both provider and payor perspectives. Its strong emphasis on evidence-based practice helps ensure that disease managers are using the best evidence to formulate the best results. Comprehensive, targeted content makes it one of the only resources available for practicing disease managers Wide variety of coverage includes chronic illnesses such as congestive heart failure, as well as management of those conditions such as pregnancy that do not indicate an unhealthy or diseased state Expert author contributions offer practical guidance and interdisciplinary perspectives Chapters provide case studies or case scenarios to demonstrate the ways in which case managers nationwide have responded to treatment challenges with success Emphasis on preventive care stresses the most practical and cost-effective solution to today's rising health care costs Authors detail specific tips, tools, and techniques that managers can put to use in practice Chapters are organized into three separate parts to present the information logically



Nursing Case Management

Nursing Case Management Author Suzanne K. Powell
ISBN-10 UOM:39015034913486
Release 1996
Pages 392
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Nursing Case Management has been writing in one form or another for most of life. You can find so many inspiration from Nursing Case Management also informative, and entertaining. Click DOWNLOAD or Read Online button to get full Nursing Case Management book for free.



The Case manager s guide

The Case manager s guide Author Alice Easterling
ISBN-10 UOM:39015038608777
Release 1995-11-15
Pages 203
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This easy-to-use personal guide for new and aspiring case managers shows how to build the skills and competencies required for success. This essential self-assessment, skill-building toolkit includes customizable job descriptions, a critical pathway worksheet, histogram and Pareto chart examples, a practice work plan, and four effective models for successfully implementing continuous quality improvement.



A Case Manager s Study Guide

A Case Manager s Study Guide Author Denise Fattorusso
ISBN-10 9781449667443
Release 2013
Pages 422
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Using Nursing Case Management to Improve Health Outcomes

Using Nursing Case Management to Improve Health Outcomes Author Michael Newell
ISBN-10 UOM:39015038406008
Release 1996
Pages 289
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Nursing



The Leader s Guide to Hospital Case Management

The Leader s Guide to Hospital Case Management Author Stefani Daniels
ISBN-10 0763733547
Release 2005
Pages 329
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This text addresses the role of the hospital care manager from a business perspective rather than a nursing perspective. It speaks to the relationship the case manager has with the executive team, managed care contracting office, decision support specialists, as well as medical staff and clinical providers and reveals the value of engaging all of them as allies in pursuit of global objectives on behalf of every stakeholder.



Core Skills for Hospital Case Managers

Core Skills for Hospital Case Managers Author Tony Cesta
ISBN-10 9781601463531
Release 2009-06-01
Pages 314
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Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. "Core Skills for Hospital Case Managers" is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills.Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders



Nurse Case Management Specialty Review and Study Guide

Nurse Case Management Specialty Review and Study Guide Author Frank Thompson
ISBN-10
Release 2015-09-25
Pages
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Includes: Multiple choice fact, scenario and case-based questions Correct answers and explanations to help you quickly master specialty content All questions have keywords linked to additional online references The mission of StatPearls Publishing is to help you evaluate and improve your knowledge base. We do this by providing high quality, peer-reviewed, educationally sound questions written by leading educators. StatPearls Publishing



CMSA Core Curriculum for Case Management

CMSA Core Curriculum for Case Management Author
ISBN-10 0781779170
Release 2008
Pages 629
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This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a "synthesis of case management evolution," and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references.



Case Management in Health Care

Case Management in Health Care Author Peggy Rossi
ISBN-10 0721695582
Release 2003
Pages 805
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Case Management in Health Care is a comprehensive reference designed to educate nurses and other health care professionals on the processes involved in case management. This reference discusses interventions and collaboration efforts that are necessary to move the patient through the continuum of care. It explores the changes in case management and it explains the financial, legal, and service aspects of this field. It is appropriate for nursing students (undergraduate and graduate) as well as for practicing case managers. Focuses on the most current topics that are based on the changes and trends in case management and health care. Addresses health care policies, laws and regulations as they apply to a case manager's day-to-day responsibilities. Presents the basics on health insurance and the alternate funding programs equipping case managers to become active advocates for their patients. Explores the pitfalls and barriers frequently encountered when locating appropriate patient resources, and explains how to overcome them. Discusses various levels of care and treatment settings outside the acute care setting (ex. skilled nursing facility and home health care). Explains the increasing number of case management models that are being used in various clinical settings. Compares the roles and responsibilities of a utilization manager and a case manager, emphasizing the need for their collective efforts in providing quality patient care. Case Management and Technology, focuses on systems support, technology tools and resources, meaningful reporting, using the Internet, and video conferencing in relation to effectively serving patients. Quality Management for Case Managers, covers guidelines for quality management, organization standards and practices, accountability, increasing customer satisfaction, and measuring utilization and costs. Audits, identifies auditing entities and discusses development of successful competency programs to meet regulatory standards specific to case management. The Importance of Credentialing, discusses the significance of credentialing as the start of the quality process of an organization. Discusses new modalities for case management such as demand management, care management, drug state management, and disability management. Addresses the complexity of the moral and ethical issues facing today's case managers. Includes content on worker's compensation, on-site vs. telephonic case management, and tools to improve the case management practice. Tips and training tools for care givers are updated to include agencies, literature, and various web sites dedicated to care giving. Expanded content on legal and legislative issues such as the Balanced Budget Act (BBA), Emergency Medical Treatment and Active Labor Act (EMTALA), and Health Insurance Portability and Accountability Act (HIPPA). Provides current coverage of funding and insurance programs such as Medicare, Medicaid, Children's health coverage, Veteran's benefits, and TRICARE. Content in Complex Care and Post Acute Care units have been expanded to include the latest advances in emergency care, hospice, and managing geriatric, transplant, mentally ill patients. Each chapter begins with Objectives that list key points and focus the reader on essential content to better prepare them for learning. Suggested Websites and Resources listed at the end of chapter provide reader with opportunity for further study and research. End of Chapter Exercises (1-5 questions) promote active learning and application of pertinent content. An AJN Book of the Year Award winner!



The Case Managers Survival Guide

The Case Managers Survival Guide Author Toni G. Cesta
ISBN-10 1605952885
Release 2016-08-02
Pages 522
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Revised, updated, expanded edition of essential book for case managers in nursing, healthcare and other professional disciplines New information on the ACA, value-based purchasing, accountable care organizations, emerging reimbursement methods, transitions of care, changing accreditation standards and much more A proven textbook for university courses, CCM exam prep, and continuing education Hundreds of case studies, finance formulas, practical pointers and sample problems The third edition of this important book adds over 10 years of new data, facts and experience needed by professional case managers, administrators and students of case management. This new edition incorporates the impacts of the Patient Protection and Affordable Care Act, value-based purchasing methods, care coordination strategies, transition planning, and case management software. Like the previous editions, the book is written to assist the professional and student, especially in the field of nursing, with practical guidance for understanding and mastering the techniques of managing cases in multiple healthcare settings: pre-acute, acute, and post-acute. At once practical and comprehensive, the new and expanded edition provides recent financial, legal and medical information required by case managers to succeed in the evolving environment of healthcare delivery. The result is an essential resource for individuals and interdisciplinary teams from many professional backgrounds, who can use the know-how in this volume for coordinating care, containing costs, and improving quality and the patient experience. The Case Manager's Survival Guide is also a proven textbook, used by hundreds of instructors and students in university and continuing education courses, as well by those preparing for the CCM exam.



Leadership and Nursing Care Management E Book

Leadership and Nursing Care Management   E Book Author Diane Huber
ISBN-10 9780323293419
Release 2014-03-12
Pages 560
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Uniquely organized around the AONE competencies, this trusted resource gives you an easy-to-understand, in-depth look at today’s most prevalent nursing leadership and management topics. Coverage features the most up-to-date, research-based blend of practice and theory related to topics such as: the nursing professional's role in law and ethics, staffing and scheduling, delegation, cultural considerations, care management, human resources, outcomes management, safe work environments, preventing employee injury, and time and stress management. UNIQUE! Chapters divided according to AONE competencies for nurse leaders, managers, and executives. Research Notes in each chapter summarize relevant nursing leadership and management studies and highlight practical applications of research findings. Case Studies at the end of each chapter present real-world leadership and management situations and illustrate how key concepts can be applied to actual practice. Critical Thinking Questions at the end of each chapter present clinical situations followed by critical thinking questions to help you reflect on chapter content, critically analyze the information, and apply it to the situation. NEW! Full-color design makes content more vivid and realistic. NEW! Chapter on Communication and Care Coordination covers these integral topics. NEW! Updates to critical thinking exercises, case studies, research notes, and references offer the most current information. NEW! Updated sections on Current Issues and Trends reflect the latest topics in the field. NEW! Relevant Web Sites boxes provide authoritative resources for additional research.



A Case Manager s Study Guide

A Case Manager s Study Guide Author Crystal Run Healthcare Rock Hill New York Denise Fattorusso
ISBN-10 9781449667450
Release 2012-06-01
Pages 400
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A Case Manager's Study Guide: Preparing for Certification, Fourth Edition is the perfect study guide for new case managers preparing to take the Certified Case Manager (CCM) exam and practicing case managers who are recertifying. Based on the Commission for Case Manager Certification (CCMC) six knowledge domains and eight essential activities, it addresses new changes passed and legislative updates resulting in significant changes in healthcare and case management. New topics include patient-centered care, readiness to change, evidence-based case management, and management outcomes. Completely updated and revised, A Case Manager's Study Guide: Preparing for Certification, Fourth Edition contains nearly 700 questions and comprehensive answer rationales. Included with the book is an online Access Code for Navigate TestPrep, a dynamic and fully hosted online assessment tool designed to help nurses prepare for certification examinations by offering case-based questions, detailed rationales, and robust reporting. Navigate TestPrep: A Case Manager's Study Guide also sold separately. * Randomized questions create new exams on each attempt * Monitors results on practice examinations with score tracking and time on each task * Reporting tools evaluate progress and results on each attempt Don t forget to visit our nursing certification website: www.NursingCertificationSuccess.com.



The Case Manager s Handbook

The Case Manager s Handbook Author Catherine Mullahy
ISBN-10 0763777242
Release 2010-10-25
Pages 875
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Written by renowned author Catherine Mullahy, The Case Manager's Handbook, Fourth Edition is the ultimate how-to guide for Case Managers. It is designed to define good case management, examine the case management process, and present practical procedural information. The Fourth Edition has been completely revised and updated with new references and pertinent information. This book is an excellent daily reference or can be used as a training guide for new case managers, or a teaching tool for client groups. Accompanied by a CD-ROM and a FREE Student Study Guide is available online.