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Utilization Management Workshop, Four Part Series


  
Thursday, May 16, 2024 - Thursday, June 06, 2024   iCalendar Central Standard Time

Four-part series:
All sessions are from 9-11 a.m.
Thursday, May 16
Thursday, May 23
Thursday, May 30
Thursday, June 6

PROGRAM OVERVIEW
Utilization management has become much more comprehensive, encompassing resource and denial management elements. This four-part series introduces utilization management’s role in contemporary case-management models. The webinars will focus on the role of registered nurse case managers, social work case managers and other department staff who collaborate with the role of the registered nurse utilization manager. An example of a day in the life of a utilization case manager will be shared. The series will address challenges in implementing the utilization-management process and include tips and strategies for streamlining the process. There will also be an emphasis on collaboration with physicians, the interdisciplinary team, case-management department peers and payers.

LEARNING OBJECTIVES

  • Discuss the compliance requirements for utilization management.
  • Explain the role of utilization management for the registered nurse case manager.
  • Identify best practices for the utilization management role.
  • Outline medical necessity criteria in the clinical review process.

 

INTENDED AUDIENCE

  • Chief medical officers
  • Chief nursing officers
  • Compliance officers
  • Health care legal professionals
  • Quality professionals
  • Risk managers

 

SPEAKERS

Bev Cunningham has been a partner and consultant with Case Management Concepts since its inception. Cunningham has been involved in developing case management for over 25 years. Her areas of expertise include the role of case management in the revenue cycle, compliance for case-management departments, the role of the physician adviser, and effective denials and appeal management. Cunningham has achieved an accredited case manager certification from the American Case Management Association.

Toni Cesta is a founding partner of Case Management Concepts. This consulting company helps organizations design, implement and evaluate case-management departments and models, educational programs and on-site support for leadership and staff. Cesta has been active in the research and development of case management for over 25 years. Her research has included two funded studies measuring the effects of a case-management model on patients with congestive heart failure and fractured hips, measuring patient satisfaction, quality of life, and short- and long-term clinical perceptions and outcomes.

 

REGISTRATION AND FEES

  • IHA member organization series rate – $375
  • Associate member organization rate – $375
  • IHA nonmember organization rate – $575


RECORDINGS POLICY
IHA will provide recordings only to those who have registered for the program.

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