Case Management

I was a Charge Nurse for a decade in the Behavioral Health Unit, I wanted a change of nursing specialty; the Registered Nurse Care Coordinator position opened up after the nurse transferred out. My 3-day orientation was task related but not in depth of the theory. After a while I was feeling that there must be more to what I am doing and should be doing. I was googling CEU and then coincidentally the Facebook Algorithm brought up this program in my advertisement feed. 

I saw a UC San Diego Case Management ad for a few weeks and was hesitant to join because I never did an Extended learning class and there are so many online programs, I was not sure of the quality. I asked the Director of Social Workers for her opinion, and she was surprised that a 72 CEU class was available and encouraged to do it. I immediately signed up, knowing that I will have Saturdays tied down for 3 months. 
The first class, even though it was just an initial orientation of the program, That little candle that I had become a menorah of "ohhh my gosh there is so much I'm responsible for."  From that class on, I brought back to my leadership team about what needs to be improved in our process. I had meetings with my CNO, CFO, the Medical Director of the Hospital, leaders in Technology, Finance and Health information management. The whole process of UR was revamped and restructured, making it more efficient, timely, improved accuracy using evidenced based data programs for medical necessity, less denials, quicker responses, and improved appeal success and became virtually paperless. I was burning through 3 rims of paper a day and a toner a month.

Treatment Team planning has also improved with the social workers, medication adjustments, shorter stays, quicker Admin Days, and better outcome for the patients.  Each week my co workers will ask about my class and what I learned.

My confidence improved greatly when dealing with insurance that wanted to deny concurrency over the phone, negotiating for the extra time, and advocating necessary stabilization, treatment and discharge planning.

The education that was taught was from real life nurses, working in the field, with PowerPoint presentations that are meaningful, and able to discuss hypothetical situations with clinical sound knowledge. I had questions lined up for the next class and were resolved that session. The Professors also offered their emails for follow up questions, which was very handy. 
We had a class of 20 students and each student brought a new perspective with their own clinical experiences, many from out of state and out of country. That community of healthcare providers was very enriching, and I was looking forward to seeing the class weekly. 

I strongly recommended this class to a few other nurses in care coordination, and they may join in the winter session.