Alternative Learning COURSE LISTINGs

Date Available:
NOW

Course Type:
On Demand

This course will focus on the challenges and common pitfalls—both for patients and hospitals—related to wound care. The five course modules describe the most recent information about the pathophysiology of acute and chronic wounds, their risk factors, the symptoms of each, and treatment options.

Date Available:
NOW

Course Type:
On Demand

The last module looks specifically at how good utilization can translate into better outcomes for patients while also lowering costs for a healthcare organization.

Date Available:
NOW

Course Type:
On Demand

This module explains that process by looking at how transdisciplinary and inter-organizational collaboration can help prevent avoidable complications, delays in care, and hospital admissions. The module then details the breadth of the entire team, and looks at how better physician involvement—such as doing bedside rounds, leading the utilization management committee (UMC), and using a physician’s advisor—can help boost effectiveness and efficiency.

Date Available:
NOW

Course Type:
On Demand

This module explores how utilization management can improve electronic tools—namely, electronic health records (EHR) and other information technology (IT). The module first looks at the relevant data accessed through such tools, such as medical necessity information and discharge plans, and the vital role that EHRs play in preventing unnecessary errors, such as wrong medications or even wrong surgeries.

Date Available:
NOW

Course Type:
On Demand

This module looks at the outside entities and processes that shape the process of UM. It begins by looking at the various government and regulatory oversight organizations, including the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC)— which oversee hospitals—and the National Committee for Quality Assurance (NCQA) and URAC (formerly referred to as the Utilization Review Accreditation Commission), which oversee health plans.

Date Available:
NOW

Course Type:
On Demand

This module lays out the basics of utilization management, and how a case manager can execute that process in an ever-changing environment of healthcare.

Date Available:
NOW

Course Type:
On Demand

This five-module course will focus on sepsis care—an infection that has a high mortality rate, but is often associated with low understanding, both on the part of patients and healthcare professionals.

Date Available:
NOW

Course Type:
On Demand

This module looks at the problem of under-insured or uninsured patients, who often need ongoing, holistic care as well as proactive patient advocacy.

Date Available:
NOW

Course Type:
On Demand

This module details how an organization can create a process to mitigate that threat as much as possible—by managing denials but also by preventing them.

Date Available:
NOW

Course Type:
On Demand

This module begins by detailing which populations are eligible for Medicaid, and then explores how different factors (such as state regulations and the Affordable Care Act) have affected Medicaid.

Date Available:
NOW

Course Type:
On Demand

This module explores how the processes surrounding reimbursement can change when dealing with common commercial plans. It begins by looking at the different types of plans, and then explores one big factor in commercial health plans: high deductibles, which can have a significant effect on revenue flow. 

Date Available:
NOW

Course Type:
On Demand

This module looks at how working with the Medicare system offers hospitals the opportunity both to maximize its reimbursement system, while also creating a better patient experience. It begins by looking at how hospitals can acknowledge patients as consumers who want the best experience for their money, while also looking at how certain diagnoses can drive up costs for everyone involved, and fast.

Date Available:
NOW

Course Type:
On Demand

This module lays out the basics of how this system works, starting by describing the major federal plans, and then detailing what kinds of services Medicare covers.

Date Available:
NOW

Course Type:
On Demand

This module looks at the key players involved in helping to achieve an efficient, healthy revenue cycle. It begins by looking at what constitutes a healthy team—one in which the members work in a positive environment so that they can feel physically, mentally and emotionally prepared to do their jobs well.

Date Available:
NOW

Course Type:
On Demand

This module lays the foundation for how hospitals can create financial health, so that they can stay in business while also offering optimum care for patients.

Date Available:
NOW

Course Type:
On Demand

This course offers evidence-based grounding skills to bridge the gaps in a case manager’s knowledge, skills and practice regarding such skills as critical thinking and emotional intelligence as well as the practice of conflict resolution through negotiation, leadership through collaboration, and the delicate dance of dealing with difficult individuals.

Date Available:
NOW

Course Type:
On Demand

The purpose of the Population Health series is to improve the competencies of: • Managed Care Organization Case Managers (MCO CMs) in managing members who are admitted to hospitals, by providing current information on prior-authorizations, concurrent reviews and transitions of care • Hospital based Case Managers (HCMs) about criteria commercial payers use to make decisions on prior-authorizations, concurrent reviews, and transitions of care of members who are admitted to the hospital