EDUCATION AND TRAINING
EDUCATION
JMA doesn't just explain the "why, what, where, and how" of the Utilization Management Departmental processes, we explain the importance of all of the pieces that make up those processes.
MONTHLY CLASSES:
JMA conducts monthly classes to teach individuals both licensed and unlicensed who wish to learn about or how to become more proficient in Case Management, Utilization Management, Delegation Oversight, Prior Authorization. We also teach medical office management.
JMA has a staffing division that provides staffing for various clients within the healthcare industry. Please contact us for more information.
Available Courses and Training
Prior Authorization
Utilization Management (UM) helps to control healthcare costs. The Prior Authorization (PA) Department reviews physician and pharmacy requests for outpatient and elective inpatient services. From the Coordinator to the Nurse to the Medical Director, timeliness matters and each line of business (LOB) has a specified decision deadline. If PA department staff members are not properly trained, fail to keep up to date on State and Federal policy changes will translate to the PA process becoming costly due to member treatment delays with member harm as the outcome. Poor staff training and limited knowledge further translates to Corrective Action Plans (CAPS), increased member grievances which means more open CAPs for repeat deficiencies further increasing the likelihood of a Closed Panel. The MSO/IPA could also end up paying for services they are not at risk for.
Delegation Oversight
Delegation Oversight Auditing plays a pivotal role in safeguarding the integrity and quality of healthcare services. This ensures that all partner organizations strictly comply with the necessary regulations and contractual agreements. Through the execution of comprehensive audits and meticulous evaluations, the auditor verifies that every operation aligns with your health organization's commitment to excellence in quality and efficiency..
Available Courses
Case Management
Case Management course covers outpatient case management process care coordination, transitional care, HRA and ICP.
Inpatient Case Management of patient/member through all levels of an inpatient admission starting from triage with transfer to capitated facility (depending on bed availability) to acute care admission until discharged to lower level. of care (home).
Utilization Management Coordinator
JMA will instruct our students on how to become an indispensible member of the UM team as a UM Coordinator. We will teach you how to promptly, efficiently and accurately execute all aspects of the referral process. Promote the quality and cost effectiveness of medical care through strict adherence to all UM Policy and procedure.
Medical Office Manager
Instruct on medical office manager daily responsibilities involved in keeping doctor's offices, and other healthcare facilities running.