How effective and successful is your case management program? Are you validating medical necessity for each patient who comes into your facility? Are you current on, and knowledgeable about, all regulatory and federal guidelines for case management? Do you have a formal process in place to prevent and manage denials?
If you struggle to answer these questions, our Case Management Virtual Conference will help you learn how to efficiently care for patients and secure reimbursement for your facility by applying best practices. An effective case management (CM) program is critical to ensuring appropriate reimbursement for the care your facility provides. Regardless of the type of services, it is necessary that provider organizations establish consistent processes to secure payment; while also transitioning patients through the care continuum at the appropriate time.
The CM department must function at optimal levels in the current healthcare landscape and prepare to transform for future demands for a facility to obtain and sustain success. With constant changes in the healthcare industry, the CM department is key to driving positive results, both clinically and financially. During this virtual conference, participants will learn how to manage resources by ensuring sufficient care, at the right time, and at the most appropriate level. Topics will include utilization management, discharge planning, population health, and cost variation, among others.
This year’s Case Management Conference will be presented in a virtual format, with a curriculum that allows flexibility for the learner, including a mix of pre-recorded modules and scheduled live sessions. The pre-recorded modules should be viewed prior to the scheduled live sessions each day; and will be available at least one day in advance of the live sessions.
Learning Objectives
- Design and implement effective medical necessity, as well as discharge planning processes that support efficient and timely patient care
- Capture necessary metrics and outcomes to monitor a case management program
- Understand the importance of clinical documentation to your case management program
- Recognize and deploy outlined processes for physician advisor escalation, multidisciplinary rounds, and denial management
Who Should Attend
- CNOs
- Case Managers
- Case Management Leadership
- Social Workers
Presenters

Lynn Collins
Director, Clinical and Operational Improvement
QHR Health

Cindy Marks
Senior Consultant, Clinical and Operational Improvement
QHR Health

Mayra Pineiro
Senior Consultant, Clinical and Operational Improvement
QHR Health

Stacy Coon
Senior Consultant, Clinical & Operational Improvement
QHR Health

Wanda Wright
Vice President, Managed Care
QHR Health

Dan Hobbs
Senior Consultant, Revenue Cycle
QHR Health
Day 1

Module I: Measurement and Reporting

Module II: Clinical Resource Management Case Study

Module III: Denial Management

Q&A Session
Day 2

Module IV: Population Health

Module V: Discharge Planning

Module VI: Utilization Management
