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Professional Certificate in Medical Case Management

Professional Certificate in Medical Case Management

Online Program

At-a-Glance

12-24 months

$3,800

14 Units

Online

Strengthen your knowledge of healthcare systems, services, and resources so you can transition into a new role helping patients who require long-term, specialized care. Medical case managers are in demand in a variety of hospital settings, including acute care, home care, mental health care and ambulatory care.

Designed For

Individuals who are:

  • Registered Nurses (RNs) or other licensed healthcare workers

What You'll Learn

  • Understand the function and rules of the case manager within the managed care industry.
  • Obtain the practical skills needed to assure that quality care is maintained or improved -- despite pressures to reduce costs.
  • Understand the models, settings and varieties of case management.

What You Can Do With This Certificate

Positions are available in a variety of industries all over the world, and can be found in hospitals, clinics, government, or nonprofit organizations. They might include:

  • Medical Case Manager
  • Nurse Case Manger
  • Home Health Supervisor

Program Overview

Required

14 Units

“I had a rewarding, insightful and very educational experience. Many more doors are now being opened for me as I transition away from the bedside--after 20 years in nursing.”

Tracy Marshall

Registered Nurse
Littleton, CO

Earning the Certificate

Prior to enrolling, please ensure that you meet the following minimum requirements:

  • Must be a Registered Nurse or other licensed medical professional.

Professional Credit

  • California Board of Registered Nursing continuing education credit (provider #11713)
  • Qualified Professional Case Manager:
    • Meets the education requirement for RNs to become QPCM-certified.
    • Registration/ exam fees significantly discounted for program graduates.
  • Certified Case Manager (CCM) continuing education hours

The Commission For Case Management Certification administers the Certified Case Manager (CCM) designation.

For more information see How to Earn a Certificate

Certificate Courses

Our certificate programs are designed to be flexible, allowing you the option to take just a few courses or to earn the complete certificate. If choosing to complete the certificate, we recommend you get the most out of your experience by following the suggested completion path below.

Quarter 1

Effective Case Management: Connecting to Healthcare Systems

BMSC X415

2 units

Principles of managing client services and support needs while maintaining fiscal viability. Explore case management processes in a variety of settings such as:

  • Acute hospital and managed care
  • Worker compensation and disability
  • Community-based case management
  • Types of insurance related to the CM process
  • Community-based organizations and agencies
  • Alternative services

Effective Case Management: Connecting to the Community

BMSC X414

2 units

Various models of case management, the process and functions of case management, and the historical context of case management are discussed. Topics include:

  • Historical origins of and recent developments in case management.
  • Removing barriers through interagency and inter-professional collaboration.
  • Service monitoring and evaluation.
  • Resource mobilization
  • Technical assistance
  • Case consultation

Quarter 2

Introduction to Life Care Planning (LCP)

BMSC X417

1.5 units

This course examines the Life Care Plan (LCP), its uses and methodology, including:

  • The interview
  • Medical record review
  • Collaboration with treatment team
  • Needs assessment
  • Report writing

Job Analysis by the Field Case Manager

BMSC X413.2

1.5 units

Case managers are often asked to evaluate a patient's readiness to return to work by analyzing the workplace environment and work tasks in relation to the patient's medical condition, injury or disability. This course:

  • Explores the skills required by the nurse or field case manager to assess a patient's job capability effectively.
  • Discusses how to make recommendations for workplace modifications.
  • Identifies the opportunities and resources available to nurses and field case managers to support these activities.

Quarter 3

Clinical Ethics

BMSC X413.11

2 units

Impact of ethics on clinical decision making, treatment choices and a patient's clinical outcome; the effective tools to help manage a variety of clinical situations, conflicts and cases; and life-and-death issues now being encountered in the increasingly complex health care system.

Medical Case Management in the Field

BMSC X413.1

1.5 units

Prepares the nurse case manager for performing case management activities in the field. Topics include:

  • Initial interviews with patients and clients in the home or community setting, and the importance of goal-directed planning
  • Arranging and attending physician appointments
  • Communication and collaboration skills
  • Problem solving
  • The evaluation of the patient level of engagement
  • Education needed to promote successful outcomes

Quarter 4

Utilization Review and Quality Management in Health Services

BMSC X410

2 units

Successfully used tactics such as case manager teams, clinical pathways and physician-staffed utilization review committees to manage patient care under capitation to ensure proper resource utilization are examined. This course explores promotion of physician involvement and negotiating the transition to capitation successfully.

Hospital-Based Case Management

BMSC X413

1.5 units

Explores the role of and tasks performed by the nurse case managers based in acute hospitals. The course provides you with an understanding of:

  • Concurrent utilization reviews
  • Discharge planning processes, such as discharge screening and assessment
  • Hospital case management issues
  • Ways to differentiating case management from care management
  • Methods for handling denials
  • Continuity of care
  • Alternative resources
  • Financial considerations

“The online delivery of this program is a perfect fit for me. I enjoy everything about hospital case management. It is both challenging and rewarding everyday. I share my love for the field through teaching, and I hope to encourage and assist those on the journey into case management.”

Tonya Smith

Social Worker & Case Manager
ER Department-Winter Haven Hospital
Winter Haven, FLA

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