Insurance, Reimbursements & Managed Health Care

Course overview

This online CE course is a comprehensive course in Managed Care, as well as the insurance industry in general. Students will examine a comprehensive and foundational overview of the history of health insurance, and in particular Managed Care. The text book used is most current and up to date and provides students with the latest policies and changes regarding health insurance and benefits as well as political processes that have affected such changes in the market place. The content in this course moves from intermediate level content to more advanced course content. Included is comprehensive content on health benefit plans and the various types of health plans and payers today. All types of plan contracts are examined as well as many types of cost structures as well as risk sharing models. Students will examine in depth Medicare, Medicare Advantage Plans, and Medicaid Plans. Also presented is Quality management and improvement related to Managed Care. Provider Networks and Integrated Delivery Systems are also studied. This course is ideal for Nurse Case Managers, as well as Nurses in management, director and administrative positions. This course may be applied for credits toward several Certification programs offered by the provider. Text book for the course must be purchased. Online classroom with faculty mentoring as need. Open enrollment. Fifty contact hours of CE.