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Training Nurses In Case Management Services That Generate Revenue

by Admin

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Case management in hospitals and health care delivery systems represent a large range of services and diverse methods of organizational structure. The concept of case management conveys various meanings to individuals and organizations.

Case management is a collaborative practice model that includes patients, nurses, social workers, physicians, other practitioners, caregivers, and the community. The case management process covers communication and facilitates care along a continuum through effective resource coordination. The goals of case management are to achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient’s right to self-determination.

As a manager/supervisor of a public health agency, your job is to ensure that things are not only running smoothly but to generate as much revenue as possible. Having a variety of nurses that can fulfill various case management services through training can increase your revenue cycle to better levels. Here are some nurses in case management serves that generate revenue.

 

Targeted Case Management (TCM)

Targeted case managers are social and human service assistants that provide clients with services. These include support for families, in a wide variety of fields, such as psychology, rehabilitation, and social work. They assist other workers, such as social workers, and they help clients find benefits or community services. These social and human service assistants help clients assess and gain benefits and services.

In addition to initially connecting clients with benefits or services, they may also follow up with clients to ensure that they are receiving the intended services and that the services are meeting their needs. They work under the direction of social workers, psychologists, or other social and human service workers.

 

Training

Requirements for becoming a TCM can vary, although they typically have at least a high school diploma and must complete a brief period of on-the-job training. Certain employers will usually prefer to hire workers who have additional education or experience under their belt.

Although a high school diploma is normally required, certain employers will prefer to hire workers who have relevant work experience or education that passed high school. A certificate or an associate degree in a subject such as human services, gerontology, or social or behavioral science can be common for workers who become a part of this occupation.

Human service degree programs will train their students to observe and interview patients, carry out treatment plans, and handle people who are experiencing a crisis. Tons of programs include fieldwork to give students hands-on experience. The level of education that TCM nurses have completed can determine the responsibilities they are given. Those with only a high school diploma are typically stuck doing lower-level work, such as helping clients fill out paperwork. Nurses with some college education may coordinate program activities or manage a group home.

 

Maternal, Child, & Adolescent Health (MCAH)

The Maternal, Child, and Adolescent Health (MCAH) provides services for each step of the way. From pregnancy to motherhood, infancy to childhood, adolescent to adult, improving the health and well-being of families across the community. Public health agencies play an important role in coordinating the broader public health system to improve the health of women, children, and adolescents. MCAH program strengthens the capacity of public health agencies to effectively ensure and assess the health of women, children, and adolescents by providing learning opportunities. Developing tools and resources, providing technical support, and facilitating peer exchange.

 

Training

This program is designed for public health professionals who already gained an advanced degree ( meaning health professional with experience in health services for maternal, child and adolescent populations including physicians, nurses, dentists, social workers and psychologists), along with those who demonstrate great potential for leadership and have a keen interest in research, such as quantitative data collection and analysis.

During their time training in this program, your nurses will learn the following skills. How to discuss major health and social problems facing maternal, child and adolescent population from demographic, health, social, political and community perspectives, as well as the scientific basis for these concerns and methods to address them. Furthermore, they’ll describe the historical roots and current structure of maternal, child and adolescent health services in the United States, these include Title V legislation and be capable of discussing the core values and strategic objectives that necessitate a special focus on these population to promote equity in health care.

They will also be able to assess any major source of information connected to these populations, identify their strengths and limitations, and use population data to assist in determining the needs of the population to design programs, formulate policy, and conducting research or training. Additionally, they shall learn the basic principles and applications of quantitative research and epidemiology for addressing issues and demonstrating expertise in these skills by completing a milestone research project.

 

Coordination of Community Services (CCS)

Coordination of Community Services are people whose communities are always close to their hearts. They enjoy helping others and making a positive impact on their immediate and surrounding community. They excel at management, making and maintaining schedules, and working with the public. Becoming a coordinator of community services requires the person to have a bachelor's degree along with relevant experience volunteering in a position that serves the community.

CCS will assist individuals with intellectual/developmental disabilities and their families in learning and gaining access to resources in their community, planning for their future, and accessing necessary services and supports. The main goal of CCS is to promote services that are planned and delivered in a manner that encourages self-sufficiency, health and safety, real community participation, and the individual's desired quality of life by:

●      Assuring the provision of Targeted Case Management (TCM) services provided to individuals being served

●      Ensuring the needs of individuals and families are met

●      Implementing standardized competency-based training

●      Enhancing Services, Processes, and Policies

 

Training

While there’s not a specific subject that needs to be majored in to become a CCS, but they should have a bachelor's degree or higher in the Human Services field. They will also need three strong years of case management experience working with individuals with intellectual and/or developmental disabilities. Three strong years of managing a caseload of 40 (or higher) individuals with intellectual and/or developmental disabilities. Extensive knowledge about Developmental Disabilities Administration (DDA) policies, procedures, service delivery systems, community resources, and Medicaid. Additionally, having experience with the LTSS system and Targeted Case Management, along with the capability to asses the caseload’s needs during all monitoring visits, phone calls, and other interactions with individuals and/or their family.

They will also gain the ability to establish and maintain working relationships, respond to individuals in a timely fashion, and utilize independent judgment and initiate access to services. More so, they will also be capable of facilitating the empowerment of individuals through promoting independence, self-determination, and creativity. They will also learn how to properly bill units and log notes into the LTSS system.

 

Child Health and Disability Prevention (CHDP)

The Child Health and Disability Prevention (CHDP) is a preventive program that allows periodic health assessments and services to low-income children and youth. CHDP provides care coordination to assist families and medical appointment scheduling, transportation, and access to diagnostic and treatment services. CHDP exams help parents and family learn about possible risk to infants, children, and youth of specific ages, and what to do to avoid them. It also provides information to families about topics such as dental care, nutrition, lead poisoning, and anemia.

Public health agencies carry out community activities which include planning, evaluation and monitoring, case management, informing, providing health education materials, providers, recruitment, quality assurance, and client support services such as assistance with transportation and medical, dental and mental health appointment scheduling and encouraging the completion of an application for ongoing health care.

 

Training

Child Health and Disability Prevention training usually consist of training modules that include PowerPoint presentations, handouts, clinical tools, practice worksheets, and other resources on the following.

Childhood Growth

●      Using World Health Organization (WHO) Growth Charts

●      How to Accurately Weigh and Measure Children

●      Assessing Child Growth Using BMI Growth Charts

Childhood Obesity

●      Promoting Healthy Weight at CHDP Well-Child Exams

●      Glucose and Cholesterol Screening for Pediatric Obesity

Promoting Physical Activity

●      Promoting Physical Activity at Well-Child Visits

 

Nurse-Family Partnership (NFP)

The Nurse-Family Partnership (NFP) provides a nurse with specialized training, education, and resources so that you can provide the best possible care to young mothers. With both in-person and distance learning opportunities, nurses will be able to participate in the main education program built to teach the skills needed to establish successful therapeutic relationships with clients. The program also comes with instructions in the visit-to-visit guidelines to ensure that the Nurse-Family Partnership program is delivered with fidelity all over the country so that goals for each client are met with success.

A nurse's education will continue with regular team meetings with nursing supervisors and staff members from the National Service Office/ These are constructed to help you continually improve your skills in communications, problem-solving and developing professional relationships. Through regular meetings and case conferences, nurses will have the chance to console with other members of the tea on addressing difficult personal and health-related predicament among clients. These meetings also provide a community of professional support with colleagues experiencing many similar excitement and upheavals as you.

 

Training

As a nurse for the Nurse-Family Partnership (NFP), you’ll be placed n a vital role in the lives of young mothers and their children. By visiting the families in their homes, and helping mothers and their partners through their pregnancies and until their children have reached the age of 2 years old, making them a relaxed and confident parent. You can help them assess their strengths and guide them to achieve a successful future for themselves and their children.

The program’s scheduled home visit each first-time mother over a two and a half year period provide content that is designed on client request, nursing assessment and program topics. Although concentrating on the new mother, the baby’s father, and other family members are also encouraged to participate.

The benefits of this program have shown positive results; these include:

●      Mothers access prenatal care, improve their diets, and reduce their use of tobacco, alcohol, and illegal substances.

●      First-time moms are better prepared emotionally for the arrival of the babies.

●      New mothers develop the skills to care for themselves and their children and identify developmental milestones and educational opportunities.

 

Conclusion

There you have it, all the programs available for any public health agency to expand their business. Training your nurses to have the skills necessary to handle these programs can improve your revenue to great heights, and provide more options for your clients.