NU433 Case Management Across the Continuum of Care

NU433: Unit 4 Assignment

Assignment Details

For this Assignment, please read the following scenario:

You are a case/care manager working for a large university hospital system. As a case/care manager, you are considered an expert on understanding resource management. The case/care management department is expanding and will be hiring new nurses. Your supervisor has asked you to help orientate the new staff. Since you are an expert in resource management you will oversee teaching the new staff about this aspect of case/care management. You will have thirty minutes to present a PowerPoint® presentation covering the following topics: utilization management, payer sources/reimbursement, support services, negotiating for benefits and support services.

Note: While you will not be required to actually present your PowerPoint to the class, your work should keep the time limit in mind in terms of the scope of your presentation. Your PowerPoint should be no more than 12-15 slides.

Create a PowerPoint presentation addressing the following:

  • Utilization Management
    • Authorizations
    • Denials and Appeals
    • Discharge Planning
  • Payor Sources and Reimbursement
    • HMO
    • PPO
    • POS
    • Medicare
    • Medicaid
    • Tricare
    • Disability
    • Worker’s Compensation
    • Uninsured/Charity
  • Support Services
    • Community and support resources
    • Medical supplies and durable medical equipment
    • Benefit and payment options for support services
  • Negotiating for Benefits and Payor Sources
    • How to Negotiate
    • Best Practices for Negotiation

Additional Requirements:

  • Include detailed Speaker’s Notes on all slides
  • Presentation should be between 12-15 slides
  • Audience: Registered Nurses pursuing career in care/case management
  • Target Clientele: Chronically Ill Adults
  • References: at least five scholarly references

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above)
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary;
  • utilize spelling and grammar check to minimize errors; and
  • review APA formatting and citation information found in the Writing Center, online, or elsewhere in the course.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well orderedlogical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th edition format for organization, style, and crediting sources including:
    • properly formatted header
    • 12-point, double-spaced, Times New Roman font
    • use of in-text citations
    • title page and reference page
    • use of headings (if applicable)

Submit the Assignment to the unit Dropbox before midnight on the last day of the unit.

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