Case Management Business Requirements

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  case management business requirements: CMSA's Integrated Case Management Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN, Rebecca Perez, MSN, RN, CCM, FCM, Corine Latour, PhD, RN, 2018-01-28 Written by case managers for case managers, this reference manual for nurses and other health professionals presents a CMSA tested approach towards systematically integrating physical and mental health case management principles and assessment tools. Since the health care field has undergone major changes such as the passing of the Patient Protection and Affordable Care Act, Mental Health Parity, Transition of Care & Chronic Care Management and the Medicare Act and CHIP Authorization Act (MACRA), health care workers must competently know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. CMSA’s Integrated Case Management delves into the role of the case manager and unpacks how case managers assess and treat complex patients. These are patients who may be challenged with medical and behavioral conditions, poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, digital and telemedicine, and new performance measures that are clearly defined for nurses in nursing terminology, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. All content aligns with the newly revised 2017 Model Care Act, CMSA Standards of Practice 2016 as well as the CMSA Core Curriculum for Case Management Third Edition.
  case management business requirements: Case Management Di Gursansky, Judy Harvey, Rosemary Kennedy, 2003-01 -- David P. Moxley, Wayne State University
  case management business requirements: Social Work Case Management Betsy Vourlekis, 2017-07-05 This new practice text provides a series of readings focusing on case management in a number of fields and in a variety of settings with different client populations. Each chapter examines a major component of case management practice by presenting information about an innovative program from a different location around the country. In conjunction, these readings provide a road map to social work case management.In addition to offering up-to-date practice approaches and examining the functions and skills of case management in depth, the authors provide the policy information needed for putting this traditional form of social work practice into today's service delivery context.
  case management business requirements: The Case Manager's Handbook Catherine M. Mullahy, 2013-06-20 Written by renowned author Catherine Mullahy, The Case Manager’s Handbook, Fifth Edition is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the Certified Case Manager (CCM) exam, and most importantly, advance their careers after the exam. Written for all professionals in all practice settings in case management, it uses real-life examples and an easy-to-read, conversational style to examine the case management process while presenting practical procedural information. An excellent daily reference and training guide for new case managers and seasoned professionals in various setting, The Case Manager’s Handbook, Fifth Edition is the “go-to” resource for facing the day-to-day challenges of case management, especially as the nation navigates through the many changes introduced by the landmark Patient Protection and Affordable Care Act. Significantly updated and revised, it contains eight new chapters: * Hospital Case Management: Changing Roles and Transitions of Care * Patient Centered Medical Home, ACOs, Health Exchanges * Evidence-Based Practice * Public Sector Reimbursement * Predictive Modeling * Pain Management * Health Technology, Trends, and Implications for Case Managers * The Affordable Care Act of 2010: Implications for Case Managers Included with each new print book is an Access Code for a Navigate Companion Website for students with objectives, multiple choice questions, and bonus appendices.
  case management business requirements: Best Practices for Knowledge Workers: Innovation in Adaptive Case Management Nathaniel Palmer, 2017-10-20 Best Practices for Knowledge Workers describes ACM, in non-technical terms, in the current era of digitization, Internet of Things (IoT), artificial intelligence (AI), intelligent BPMS and BPM Everywhere. Business readers will learn how support of adaptive, data-driven processes empowers knowledge workers to know in real-time what is happening at the edge points, and to take actions through the combination of rule-driven guidance and their own know-how. It is not a traditionally-automated system but intelligent automation, where technology doesn’t merely replace human decision-making but extends the reach of the knowledge worker; making IoT data actionable. Highly predictable work is easy to support using traditional programming techniques, while unpredictable work cannot be accurately scripted in advance, and thus requires the involvement of the knowledge workers themselves. The core element of Adaptive Case Management (ACM) is the support for real-time decision-making by knowledge workers. In award-winning case studies covering industries as a diverse as law enforcement, transportation, insurance, banking, state services, and healthcare, you will find instructive examples for how to transform your own organization. This important book follows these ground-breaking best-sellers on ACM; Thriving on Adaptability, Empowering Knowledge Workers, Taming the Unpredictable, How Knowledge Workers Get Things Done, and Mastering the Unpredictable and provides important papers by thought-leaders in this field, together with practical examples, detailed ACM case studies and product reviews
  case management business requirements: Advanced Case Management with IBM Case Manager Wei-Dong Zhu, Brian Benoit, Bob Jackson, Johnson Liu, Mike Marin, Seema Meena, Juan Felipe Ospina, Guillermo Rios, IBM Redbooks, 2015-04-28 Organizations face case management challenges that require insight, responsiveness, and collaboration. IBM® Case Manager, Version 5.2, is an advanced case management product that unites information, process, and people to provide the 360-degree view of case information and achieve optimized outcomes. With IBM Case Manager, knowledge workers can extract critical case information through integrated business rules, collaboration, and analytics. This easy access to information enhances decision-making ability and leads to more successful case outcomes. IBM Case Manager also helps capture industry preferred practices in frameworks and templates to empower business users and accelerate return on investment. This IBM Redbooks® publication introduces the case management concept. It includes the reason for and benefits of case management, and why it is different from the traditional business process management or content management. In addition, this book addresses how you can design and build a case management solution with IBM Case Manager and integrate that solution with external products and components. This book is intended to provide IT architects and IT specialists with the high-level concepts of case management and the capabilities of IBM Case Manager. It also serves as a practical guide for IT professionals who are responsible for designing, building, customizing, and deploying IBM Case Manager solutions.
  case management business requirements: Oracle Case Management Solutions Léon Smiers, Manas Deb, Joop Koster, Prasen Palvankar, 2015-10-28 Organizations increasingly need to deal with unstructured processes that traditional business process management (BPM) suites are not designed to deal with. High-risk, yet high-value, loan origination or credit approvals, police investigations, and healthcare patient treatment are just a few examples of areas where a level of uncertainty makes outc
  case management business requirements: CMSA Core Curriculum for Case Management Hussein M. Tahan, Teresa M. Treiger, 2016-07-05 The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation
  case management business requirements: Health and Human Services Issues United States. General Accounting Office, 1993 Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's food supply. Following an overview of important issues facing the nation, the second section suggests steps to bolster public confidence in the social security system, including building the system's trust fund by increasing contribution levels and modernizing computer systems. The next section provides recommendations for continuing the welfare reform movement and the implementation of the Family Support Act, such as developing automated data systems to effectively manage caseloads, setting goal-oriented program performance standards, and identifying and sharing effective initiatives between states. The fourth section suggests that HHS provide states with greater flexibility in using government funds to prevent child abuse through early intervention and that a national foster care system be developed to provide outcome-oriented data on child welfare services. The final section proposes that an agency-wide system for tracking regulation development be implemented in the Food and Drug Administration to improve agency effectiveness and better allocate existing resources. Includes references for 22 related GAO products. (BCY).
  case management business requirements: The Leader's Guide to Hospital Case Management Stefani Daniels, Marianne Ramey, 2005 This text will address the role of the hospital case manager from a busniess perspective rather than a nursing perspective. Will engage all areas that are involved with the health care system, in pursuit of global objectives on behalf of every stakeholder.
  case management business requirements: Essential Readings in Case Management Catherine M. Mullahy, 1998 Bullets in Emergency Medicine: Review and Reminders in Pursuit of Evidence-Based Decisions is a concise guide to the diagnosis and treatment patients in the Emergency Department. Arranged by signs and symptoms as well as by system, this accessible handbook is an ideal reference for use in the Emergency Department and a perfect review for the ACEP boards.
  case management business requirements: CMSA Core Curriculum for Case Management , 2008 This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a synthesis of case management evolution, and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references.
  case management business requirements: COLLABORATE(R) for Professional Case Management Teresa Treiger, Ellen Fink-Samnick, 2015-04-15 This book is about the progressive improvement of case management beyond that which it exists to that of a practice specialty focused on professionalism and collegiality across all practice settings. Our desire to produce a framework for such practice began when we connected several years ago. It was a result of a dialogue; the sharing of our stories and experiences. Separately, we were already passionate about and committed to case management excellence. Together, our vision coalesced to form this competency-based framework for advancing case management captured by an acronym which defined the essence of professional practice---COLLABORATE. We spent hours discussing the implications of a perceived epidemic involving less than productive interactions between individuals working under the title of case manager with consumers, providers, and clinical colleagues. These accumulated experiences heightened our commitment to lead much-needed change. Our conversation endured over many months as we realized a shared: Respect for case management’s rich heritage in healthcare, across professional disciplines and practice settings; Concern for those factors which devalue case management’s professional standing; Agreement that while the practice of case management transcends many representative professional disciplines and educational levels, each stakeholder continues to cling to their respective stake in the ground; and Belief of the importance for case management to move from advanced practice to profession once and for all. COLLABORATE was borne from a vision; the mandate to solidify a foundation for case management practice which combines unique action-oriented competencies, transcends professional disciplines, crosses over practice settings, and recognizes educational levels. The ultimate focus is on improving the client’s health care experience through the promotion of effective transdisciplinary collaboration. COLLABORATE recognizes the hierarchy of competencies and practice behaviors defined by the educational levels of all professionals engaged; associate, bachelors, masters and doctoral degrees across practice disciplines. Through this approach, every qualified health and human service professional has a valued place setting at case management’s ever-expanding table. Each of the competencies are presented as mutually exclusive and uniquely defined however, all are complementary and call on the practitioner to conduct work processes in a wholly integrated manner. While appearing in order for the acronym’s sake, they are not necessarily sequential. Ultimately, case management is an iterative process. When united in a comprehensive and strategic effort, the COLLABORATE competencies comprise a purpose-driven, powerful case management paradigm. The agility of this model extends to use of key concepts that include both action-oriented verbs and nouns, which are significant elements in any professional case management endeavor. To date, case management practice models have been driven by care setting and/or business priorities. Unfortunately, this exclusivity has contributed to a lack of practice consistency due to shifting organizational and regulatory priorities. However, this is only one reason for a fragmented case management identity. COLLABORATE recognizes and leverages these important influencers as critical to successful practice and quality client outcomes. Interprofessional education and teamwork are beginning to emerge as the means to facilitate relationship-building in the workplace. Through this approach, health care practitioners absorb the theoretical underpinning of intentionally work together in a mutually respectful manner which acknowledges the value of expertise of each care team stakeholder. This educational approach provides the opportunity to engage in clinical practice that incorporates the professional standards to which we hold ourselves accountable Innovative and emerging care coordination models, defined by evidence-based initiatives, appear across the industry. Each promotes attention to interprofessional practice in order to achieve quality patient-centered care. Herein lies an opportunity to demonstrate the value drawn from diverse expertise of case managers comprising the collective workforce. However a critical prefacing stage of this endeavor involves defining a core practice paradigm highlighting case management as a profession. The diverse and complex nature of population health mandates that case management intervene from an interprofessional and collaborative stance. While inherent value is derived from the variety of disciplines, this advanced model unifies case management’s unique identity. Now is the time to define and adopt a competence-based model for professional case management. COLLABORATE provides this framework. This text is presented in four sections: Section 1: Historical validation of why this practice paradigm is critical for case management to advance to a profession; Section 2: Presentation of the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; Section 3: Practical application of the book’s content for use by the individual case manager and at the organizational level; and The Epilogue: Summarizes the COLLABORATE approach in a forward-looking context. For the reader with limited time, reviewing Section 2 provides the substantive meat associated with each of the competencies. Our ultimate desire is that the COLLABORATE approach provides an impetus for all stakeholders (e.g., practitioners, educational institutions, professional organizations) to take the necessary steps toward unified practice in order to facilitate the transition of case management considered as a task-driven job to its recognition as being a purpose-driven profession. The book provides a historical validation of why this new practice paradigm is critical for case management to advance as a profession; presents the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; and covers the practical application of the book’s content by individual case managers, and at the organizational level.
  case management business requirements: Business Process Management Workshops Manfred Reichert, Hajo A. Reijers, 2016-07-25 This book constitutes the refereed proceedings of ten international workshops held in Innsbruck, Austria, in conjunction with the 13th International Conference on Business Process Management, BPM 2015, in September 2015. The seven workshops comprised Adaptive Case Management and other Non-workflow Approaches to BPM (AdaptiveCM 2015), Business Process Intelligence (BPI 2015), Social and Human Aspects of Business Process Management (BPMS2 2015), Data- and Artifact-centric BPM (DAB 2015), Decision Mining and Modeling for Business Processes (DeMiMoP 2015), Process Engineering (IWPE 2015), and Theory and Applications of Process Visualization (TaProViz 2015). The 42 revised papers presented were carefully reviewed and selected from 104 submissions. In addition, four short papers and one keynote (from TAProViz) are also included in this book.
  case management business requirements: Building IBM Enterprise Content Management Solutions From End to End Wei-Dong Zhu, Ben Davies, Isuru Fernando, Blair Groff, Sven Hapke, Abraruddin Khan, Johnson Liu, Josemina Magdalen, Yuki Makino, Mike Prentice, IBM Redbooks, 2014-10-22 IBM® Enterprise Content Management (ECM) solutions provide efficient and effective ways to capture content, manage the content and business processes, discover insights from the content, and derive actions to improve business processes, products, and services. This IBM Redbooks® publication introduces and highlights some of the IBM ECM products that can be implemented and integrated together to create end-to-end ECM solutions: IBM Case Manager IBM Datacap IBM Content Manager OnDemand IBM Enterprise Records IBM WatsonTM Content Analytics IBM Content Classification For each product involved in the ECM solution, this IBM Redbooks publication briefly describes what it is, its functions and capabilities, and provides step-by-step procedures for installing, configuring, and implementing it. In addition, we provide procedures for integrating these products together to create an end-to-end ECM solution to achieve the overall solution objectives. Not all of the products are required to be integrated into an ECM solution. Depending on your business requirements, you can choose a subset of these products to be built into your ECM solutions. This book serves as a hands-on learning guide for information technology (IT) specialists who plan to build ECM solutions from end-to-end, for a proof of concept (PoC) environment, or for a proof of technology environment. For implementing a production-strength ECM solution, also refer to IBM Knowledge Center, IBM Redbooks publications, and IBM Software Services.
  case management business requirements: An International Guide to Patent Case Management for Judges World Intellectual Property Organization, 2023-04-19 Produced with the support of the University of California at Berkeley School of Law and the Berkeley Judicial Institute, this Guide highlights the progress achieved in patent case management in ten patent-heavy jurisdictions. The Guide offers an overview of the patent system in each jurisdiction, including the role of patent offices in evaluating and deciding on patent validity, and the judicial structures responsible for resolving patent disputes. Thereafter chapters are structured on the different stages of patent litigation in civil infringement cases. Readers can create their own custom guide by selecting any combination of jurisdictions and topics covered in the Guide. Please see the Custom guide link: https://www.wipo.int/about-patent-judicial-guide/en
  case management business requirements: A Case Manager’s Study Guide Nancy E. Skinner, Stefany H. Almaden, 2018-03-20 A Case Manager's Study Guide: Preparing for Certification, Fifth Edition is an essential study guide for case managers preparing to take the Certified Case Manager (CCM) exam offered by the Commission for Case Manager Certification (CCMC). Based on the five knowledge domains and eight essential activities from the CCMC, it contains hundreds of questions and answers with comprehensive rationales. Completely updated and revised, the Fifth Edition reflects the latest CCM exam blueprint.
  case management business requirements: Strategic Information Systems: Concepts, Methodologies, Tools, and Applications Hunter, M. Gordon, 2009-08-31 This 4-volume set provides a compendium of comprehensive advanced research articles written by an international collaboration of experts involved with the strategic use of information systems--Provided by publisher.
  case management business requirements: Understanding Health Care Management Seth B. Goldsmith, 2014 This collection of case studies is designed for use in both undergraduate and graduate courses in health care administration. With contributions from a range of experts including present and former CEOs, consultants, public health officials, systems executives, departmental managers, architects, planners and entrepreneurs, this robust classroom resource brings together practical, real world examples of issues and topics that are critical to understanding the complex field of health care management.
  case management business requirements: Case Management Suzanne K. Powell, Hussein M. Tahan, 2018-02-26 Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management
  case management business requirements: Department of Homeland Security Appropriations for 2012 United States. Congress. House. Committee on Appropriations. Subcommittee on Homeland Security, 2011
  case management business requirements: Adaptive Health Management Information Systems: Concepts, Cases, & Practical Applications Joseph Tan, Fay Cobb Payton, 2009-05-21 This book covers all the fundamental concepts of Health Management Information Systems (HMIS), provides relevant and current HMIS cases throughout, and touches on emerging technologies. Topics include: information systems from a managerial perspective; roles of cio/cto for healthcare services organizations; HMIS hardware/software concepts; HMIS database concepts.Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.
  case management business requirements: ECIME2015-9th European Conference on IS Management and Evaluation Dr Elias Pimenidis and Dr Mohammed Odeh, 2015-09-07 The 9th European Conference on Information Management and Evaluation (ECIME) is being hosted this year by the University of the West of England, Bristol, UK on the 21-22 September 2015. The Conference Chair is Dr Elias Pimenidis, and the Programme Chair is Dr Mohammed Odeh both from the host University. ECIME provides an opportunity for individuals researching and working in the broad field of information systems management, including IT evaluation to come together to exchange ideas and discuss current research in the field. This has developed into a particularly important forum for the present era, where the modern challenges of managing information and evaluating the effectiveness of related technologies are constantly evolving in the world of Big Data and Cloud Computing. We hope that this year’s conference will provide you with plenty of opportunities to share your expertise with colleagues from around the world. The keynote speakers for the Conference are Professor Haris Mouratidis, from the School of Computing, Engineering and Mathematics, University of Brighton, UK who will address the topic “Rethinking Information Systems Security”, Dr Mohammed Odeh, from the University of the West of England, Bristol, UK and Dr. Mario Kossmann from Airbus, UK who will talk about “The Significance of Information Systems Management and Evaluation in the Aerospace Industry’ ECIME 2015 received an initial submission of 55 abstracts. After the double-blind peer review process 28 academic Research papers, 5 PhD Research papers, 1 Masters Research paper and 3 Work in Progress papers have been accepted for these Conference Proceedings. These papers represent research from around the world, including Austria, Botswana, Cyprus, Czech Republic, Ireland, Japan, Kuwait, New Zealand, Norway, Poland, Portugal, Slovakia, Russia, South Africa, South Korea, Sweden, The Netherlands, UK and the USA.
  case management business requirements: Long-term-care Case Management United States. General Accounting Office, 1993
  case management business requirements: Digital Business and Intelligent Systems Mirjana Ivanovic, Marite Kirikova, Laila Niedrite, 2022-06-27 This book constitutes the refereed proceedings of the 15th International Baltic Conference on Digital Business and Intelligent Systems, Baltic DB&IS 2022, held in Riga, Latvia, in July 2022. The 16 revised full papers and 1 short paper presented were carefully reviewed and selected from 42 submissions. The papers are centered around topics like architectures and quality of information systems, artificial intelligence in information systems, data and knowledge engineering, enterprise and information systems engineering, security of information systems.
  case management business requirements: Project Management Excellence H. James Harrington, Thomas McNellis, 2006
  case management business requirements: Daily Graphic Ransford Tetteh, 2014-04-03
  case management business requirements: Business Process Management Workshops Cristina Cabanillas, Niels Frederik Garmann-Johnsen, Agnes Koschmider, 2023-02-10 This book constitutes revised papers from the International Workshops held at the 20th International Conference on Business Process Management, BPM 2022, in Münster, Germany, during September 11-15, 2022. Papers from the following workshops are included: · 6th International Workshop on Artificial Intelligence for Business Process Management (AI4BPM 2022) · 6th International Workshop on Business Processes Meet Internet-of-Things (BP-Meet-IoT 2022) · 18th International Workshop on Business Process Intelligence (BPI 2022) · 2nd International Workshop on Business Process Management and Routine Dynamics (BPM&RD 2022) · 14th International Workshop on Social and Human Aspects of Business Process Management (BPMS2 2022) · 1st International Workshop on Data-Driven Business Process Optimization (BPO 2022) · 10th International Workshop on DEClarative, DECision and Hybrid approaches to processes (DEC2H 2022) · 1st International Workshop on Natural Language Processing for Business Process Management (NLP4BPM 2022) Each of the eight workshops focused on particular aspects of business process management. Overall, after a thorough review process, there were 23 full and 3 short papers selected from a total of 51 submissions. Only one of the short papers is included in the proceedings.
  case management business requirements: The Case Manager's Training Manual David W. Plocher, Patricia L. Metzger, 2001 Stem Cell and Bone Marrow Transplantation
  case management business requirements: The Integrated Case Management Manual Roger G. Kathol, Rachel L. Andrew, Michelle Squire, Peter J. Dehnel, 2018-06-14 Thoroughly revised and updated since its initial publication in 2010, the second edition of this gold standard guide for case managers again helps readers enhance their ability to work with complex, multimorbid patients, to apply and document evidence-based assessments, and to advocate for improved quality and safe care for all patients. Much has happened since Integrated Case Management (ICM), now Value-Based Integrated Case Management (VB-ICM), was first introduced in the U.S. in 2010. The Integrated Case Management Manual: Valued-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition emphasizes the field has now moved from “complexity assessments” to “outcome achievement” for individuals/patients with health complexity. It also stresses that the next steps in VB-ICM must be to implement a standardized process, which documents, analyzes, and reports the impact of VB-ICM services in removing patient barriers to health improvement, enhancing quality and care coordination, and lowering the financial impact to patients, providers, and employer groups. Written by two expert case managers who have used VB-ICM in their large fully disseminated VB-ICM program and understand its practical deployment and use, the second edition also includes two authors with backgrounds as physician support personnel to case managers working with complex individuals. This edition builds on the consolidation of biopsychosocial and health system case management activities that were emphasized in the first edition. A must-have resource for anyone in the field, The Integrated Case Management Manual: Value-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition is an essential reference for not only case managers but all clinicians and allied personnel concerned with providing state-of-the-art, value-based integrated case management.
  case management business requirements: Fundamentals of Enterprise Architecture Management Jörg Ziemann, 2022-06-22 This textbook provides a comprehensive, holistic, scientifically precise, and practically relevant description of Enterprise Architecture Management (EAM). Based on state-of-the-art concepts, it also addresses current trends like disruptive digitization or agile methods. The book is structured in five chapters. The first chapter offers a comprehensive overview of EAM. It addresses questions like: what does EAM mean, what is the history of EAM, why do enterprises need EAM, what are its goals, and how is it related to digitalization? It also includes a short overview of essential EAM standards and literature. The second chapter provides an overview of Enterprise Architecture (EA). It starts with clarifying basic terminology and the difference between EA and EAM. It also gives a short summary of existing EA frameworks and methods for structuring the digital ecosystem into layers and views. The third chapter addresses the strategic and tactical context of the EAM capability in an enterprise. It defines essential terms and parameters in the context of enterprise strategy and tactics as well as the operative, organizational context of EAM. The fourth chapter specifies the detailed goals, processes, functions, artifacts, roles and tools of EAM, building the basis for an EAM process framework that provides a comprehensive overview of EAM processes and functions. Closing the circle, the last chapter describes how to evaluate EAM in an enterprise. It starts by laying out core terminology, like “metric” and “strategic performance measurement system” and ends with a framework that integrates the various measuring areas in the context of EA and EAM. This textbook focuses on two groups: First, EAM scholars, ie bachelor or master students of Business Information Systems, Business Administration or Computer Science. And second, EAM practitioners working in the field of IT strategy or EA who need a reliable, scientifically solid, and practically proven state-of-the-art description of essential EAM methods.
  case management business requirements: A History of AIDS Social Work in Hospitals Barbara I Willinger, Alan Rice, 2012-11-12 Explore the in-hospital evolution of social work with HIV/AIDS patients! A History of AIDS Social Work in Hospitals: A Daring Response to an Epidemic presents first-hand historical perspectives from frontline hospital social workers who cared for HIV/AIDS patients during the epidemic’s beginning in the early 1980s. Contributors recount personal and clinical experiences with patients, families, significant others, bureaucracies, and systems during a time of fear, challenge, and extreme caution. Their experiences illustrate the transformation of social work as the development of new programs and treatments increased the lifespan of HIV/AIDS patients. A History of AIDS Social Work in Hospitals portrays the nature of human suffering and teaches how clients deal with adversity and overcome devastating obstacles. At the same time this book, which, while nonfiction, reads like a novel, opens a window into the world of social work providers working with an illness once considered taboo (and now referred to as simply “chronic”). A History of AIDS Social Work in Hospitals provides you with an easy-to-understand medical overview of adult and pediatric infectious diseases that often accompany HIV/AIDS and examines: the evolution of social work with hospitalized patients during the first twenty years of the pandemic the important roles of social workers in New York, San Francisco, Philadelphia, and South Carolina challenges that resulted from improved medications and longer life expectancy the status of current HIV/AIDS care programs the development of HIV/AIDS case management in emergency room settings the benefits of developing custody planning programs for HIV-infected families the challenges of working with perinatally infected adolescents With case studies and thoughtful analysis of the history of city, state, and national case management responses to the AIDS crisis, A History of AIDS Social Work in Hospitals is a valuable book for educators, students, historians, beginning mental health practitioners, social workers, case managers, substance abuse counselors, and anyone interested in stories of human courage. Make it part of your collection today!
  case management business requirements: Comprehensive Case Management for Substance Abuse Treatment Sandra Clunies, 2000-09 A Treatment Improvement Protocol on case management, which can be described as a coordinated approach to the delivery of health, substance abuse, mental health, & social services, linking clients with appropriate services to address specific needs & achieve stated goals. Case management lends itself to the treatment of substance abuse, particularly for clients with other disorders & conditions who require multiple services over extended periods of time & who face difficulty in gaining access to those services. This report details the factors that programs should consider as they decide to implement case management or modify their current case management activities.
  case management business requirements: Business Process Management Workshops Chiara Di Francescomarino, Remco Dijkman, Uwe Zdun, 2020-01-03 This book constitutes revised papers from the twelve International Workshops held at the 17th International Conference on Business Process Management, BPM 2019, in Vienna, Austria, in September 2019: The third International Workshop on Artificial Intelligence for Business Process Management (AI4BPM) The third International Workshop on Business Processes Meet Internet-of-Things (BP-Meet-IoT) The 15th International Workshop on Business Process Intelligence (BPI) The first International Workshop on Business Process Management in the era of Digital Innovation and Transformation (BPMinDIT) The 12th International Workshop on Social and Human Aspects of Business Process Management (BPMS2) The 7th International Workshop on Declarative, Decision and Hybrid approaches to processes (DEC2H) The second International Workshop on Methods for Interpretation of Industrial Event Logs (MIEL) The first International Workshop on Process Management in Digital Production (PM-DiPro) The second International Workshop on Process-Oriented Data Science for Healthcare (PODS4H) The fourth International Workshop on Process Querying (PQ) The second International Workshop on Security and Privacy-enhanced Business Process Management (SPBP) The first International Workshop on the Value and Quality of Enterprise Modelling (VEnMo) Each of the workshops discussed research still in progress and focused on aspects of business process management, either a particular technical aspect or a particular application domain. These proceedings present the work that was discussed during the workshops.
  case management business requirements: The Hospital Case Management Orientation Manual Peggy Rossi, Bsn, Mpa, CCM, Karen Zander, 2014-06-12 The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements of initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials. This book's focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate.
  case management business requirements: Comprehensive Case Management for Substance Abuse Treatment - TIP 27 U.S. Department of Health And Human Services, 2019-11-22 Case management has been variously classified as a skill group, a core function, service coordination, or a network of friendly neighbors. Although it defies precise definition, case management generally can be described as a coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals. The Consensus Panel that developed this TIP believes that case management lends itself to the treatment of substance abuse, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services. This document details the factors that programs should consider as they decide to implement case management or modify their current case management activities. This summary is excerpted from the main text, in which references to the research appear.
  case management business requirements: Nursing Case Management Elaine Cohen, Toni G. Cesta, 2004-08-26 This classic resource offers complete coverage of nursing case management - from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success. Includes numerous proven case management models currently being used in institutions across the country Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program Offers detailed guidance for planning, implementing, and evaluating a case management program Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice Presents acute care and community based models of case management Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities
  case management business requirements: Social Work Case Management Michael J. Holosko, 2017-01-30 Social Work Case Management: Case Studies From the Frontlines by Michael J. Holosko is an innovative book that equips readers with the knowledge and skills they need to be effective case management practitioners in a variety of health and human service organizations. A must-read for students and professionals in social work, this important work introduces a unique Task-Centered Case Management Model built around the unifying principles of the profession—person-in-environment, strengths-based work, and ecological perspective. Over twenty case studies by case managers and professionals offer innovative practice insights, illustrating the practice roles and responsibilities of today's case managers and the realities of conducting case management in today’s growing, exciting, and challenging field.
  case management business requirements: Life Care Planning and Case Management Handbook Subrata Ghatak, 2009-09-21 Life Care Planning is an advanced collaborative practice concerned with coordinating, accessing, evaluating, and monitoring necessary services for individuals with significant medical adversity. This handbook provides a comprehensive resource for all people involved with catastrophic impairments who need to solve complex medical care problems. Upda
  case management business requirements: Patent Case Management Judicial Guide , 2009
Chapter 49. Case Management - Louisiana Department of Health
all case managers must receive a minimum of 16 hours of training during the first 90 calendar days of employment which is related to the target population to be served and specific knowledge, …

Standards of Practice for Case Management - ABQAURP
To establish our position as providers of service and to improve our position for reimbursement of case management services, it is imperative to establish accepted qualifications for case …

Case Management Guide - Cloudinary
This case management guide details ODM’s standards and expectations related to the daily operations necessary to achieve that goal. As program changes occur, and issues and/or …

Case Management and Workers’ Compensation Case …
QTR 2-1: Professional Case Manager Orientation and . Training . QTR 3: Supervision of Professional Case Management Staff . QTR 3-1: Requirements of the Professional Case . Management …

Case Management Service Chapter- 12VAC35-110 - Virginia …
Jul 12, 2022 · Case management services include identifying potential users of the service; assessing needs and planning services; linking the individual to services and supports; assisting …

Transitioning to your new case management company
Case management is a required service and the foundation which all other HCBS services and supports are built upon. Effective January 1, 2022, the delivery of case management will be …

Case Management Business Requirements [PDF]
body of knowledge for case management practice as delineated by the Case Management Society of America CMSA the largest professional organization of case managers The core curriculum …

Case Management and Clinical Services Manual - PA.GOV
DDAP has developed the Case Management and Clinical Services Manual (CMCSM) to comply with and convey the requirements of the Substance Use, Prevention, Treatment and Recovery …

Standards of Practice for Case Management
These Standards of Practice identify and address important foundational knowledge, skills, and competencies for the professional case manager within a spectrum of case management practice …

Prosecutor Case Management System Functional Requirements
Prosecutor Case Management System Functional Requirements A standardized approach to identify and document functional requirements and application components when procuring a prosecutor …

AMPM Policy 570 - Provider Case Management - AHCCCS
Policy establishes requirements for provider case management for behavioral health providers. For members who are enrolled with an ALTCS E/PD Contractor, case management is provided by the …

CHAPTER 8: CASE MANAGEMENT - Idaho
Jun 8, 2019 · (ICOA) Case management is a consumer-driven, social model case management service that empowers individuals and their families to make choices concerning in-home, …

Case Management Services - Wisconsin
The Wisconsin Medicaid and BadgerCare Case Management Handbook is issued to case management providers who are Wisconsin Medicaid certified. It contains information that applies …

Basics of Case Management - HFMA
Feb 5, 2023 · What is the difference of Case Management & Utilization Review? Case Management: Coordinates care and assists the patient to navigate the system to attain the highest quality of …

Case Management-Only Agency Office Criteria Requirements
Case Management-Only Agency Office Criteria Requirements Policy Manual References: • Aged & Disabled Waiver (ADW): Section 501.2.2 • Traumatic Brain Injury Waiver (TBIW): Section 512.2 .2 …

Requirements For Provider Type 21 – Case Manager - PA.GOV
After gathering the documentation listed above, please read the following pages for additional requirements based on the Provider’s specific specialty type. Case Management (21) Providers …

CHAPTER FIVE Case Management Systems: Promoting …
A case management system balances the interests of the client in getting the best and speediest representation with the agency in providing services efficiently. It will include standard …

North Carolina Department of Health and Human Services …
Apr 11, 2012 · legislative requirements for a consolidated case management solution. The consensus was to focus primarily on the software solution purchased as part of the NC FAST …

CASE MANAGEMENT PRACTICE STANDARDS - yournacm.com
Practice Standards for the profession of Case Management. Historically, the term Case Management (CM) has been used in referring to various actions such as linkage and coordination …

Case Management Redesign - Minnesota's State Portal
Dec 5, 2019 · DHS and its partners recognize that case management business processes and program policy must be streamlined, simplified and aligned to achieve this. Case management …

Chapter 49. Case Management - Louisiana Department of …
all case managers must receive a minimum of 16 hours of training during the first 90 calendar days of employment which is related to the target population to be served and specific …

Standards of Practice for Case Management - ABQAURP
To establish our position as providers of service and to improve our position for reimbursement of case management services, it is imperative to establish accepted qualifications for case …

Case Management Guide - Cloudinary
This case management guide details ODM’s standards and expectations related to the daily operations necessary to achieve that goal. As program changes occur, and issues and/or …

Case Management and Workers’ Compensation Case …
QTR 2-1: Professional Case Manager Orientation and . Training . QTR 3: Supervision of Professional Case Management Staff . QTR 3-1: Requirements of the Professional Case . …

Case Management Service Chapter- 12VAC35-110 - Virginia …
Jul 12, 2022 · Case management services include identifying potential users of the service; assessing needs and planning services; linking the individual to services and supports; …

Transitioning to your new case management company
Case management is a required service and the foundation which all other HCBS services and supports are built upon. Effective January 1, 2022, the delivery of case management will be …

Case Management Business Requirements [PDF]
body of knowledge for case management practice as delineated by the Case Management Society of America CMSA the largest professional organization of case managers The core …

Case Management and Clinical Services Manual - PA.GOV
DDAP has developed the Case Management and Clinical Services Manual (CMCSM) to comply with and convey the requirements of the Substance Use, Prevention, Treatment and Recovery …

Standards of Practice for Case Management
These Standards of Practice identify and address important foundational knowledge, skills, and competencies for the professional case manager within a spectrum of case management …

Prosecutor Case Management System Functional …
Prosecutor Case Management System Functional Requirements A standardized approach to identify and document functional requirements and application components when procuring a …

AMPM Policy 570 - Provider Case Management - AHCCCS
Policy establishes requirements for provider case management for behavioral health providers. For members who are enrolled with an ALTCS E/PD Contractor, case management is …

CHAPTER 8: CASE MANAGEMENT - Idaho
Jun 8, 2019 · (ICOA) Case management is a consumer-driven, social model case management service that empowers individuals and their families to make choices concerning in-home, …

Case Management Services - Wisconsin
The Wisconsin Medicaid and BadgerCare Case Management Handbook is issued to case management providers who are Wisconsin Medicaid certified. It contains information that …

Basics of Case Management - HFMA
Feb 5, 2023 · What is the difference of Case Management & Utilization Review? Case Management: Coordinates care and assists the patient to navigate the system to attain the …

Case Management-Only Agency Office Criteria Requirements
Case Management-Only Agency Office Criteria Requirements Policy Manual References: • Aged & Disabled Waiver (ADW): Section 501.2.2 • Traumatic Brain Injury Waiver (TBIW): Section …

Requirements For Provider Type 21 – Case Manager - PA.GOV
After gathering the documentation listed above, please read the following pages for additional requirements based on the Provider’s specific specialty type. Case Management (21) …

CHAPTER FIVE Case Management Systems: Promoting …
A case management system balances the interests of the client in getting the best and speediest representation with the agency in providing services efficiently. It will include standard …

North Carolina Department of Health and Human Services …
Apr 11, 2012 · legislative requirements for a consolidated case management solution. The consensus was to focus primarily on the software solution purchased as part of the NC FAST …

CASE MANAGEMENT PRACTICE STANDARDS - yournacm.com
Practice Standards for the profession of Case Management. Historically, the term Case Management (CM) has been used in referring to various actions such as linkage and …

Case Management Redesign - Minnesota's State Portal
Dec 5, 2019 · DHS and its partners recognize that case management business processes and program policy must be streamlined, simplified and aligned to achieve this. Case management …