American Association of Managed Care Nurses
“Educating Nurses in Case, Utilization and Quality Management”
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The Nurses’ Notes Newsletter is a quarterly newsletter written by and for AAMCN members.
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Welcome to the AAMCN!
Managed care nurses are a valued resource utilized by many organizations such as health care institutions, health plans, IRO/EQRO or accreditation organizations and health care providers/vendors to ensure improved coordination and positive outcomes of clients’ care. They ensure that desired clinical outcomes can be achieved in a cost-effective manner that ultimately supports the client, the organization, and ultimately the delivery of health care.
The functions of the managed care nurse include, but are not limited to, the following:
· Clinical program development, implementation and management
· Regulatory compliance
· Provider and vendor management
· Data gathering and analysis
· Development of an integrated plan of care
· Coordination of care and services through the continuum
· Establishment, implementation and evaluation of client-centered goals
· Outcomes measurement and analysis
· Education of managed care consumers on all aspects of their healthcare
· Researching and identifying community resources
· Advocate for the consumer
We’d like to thank our Corporate Partners for their continuous support!
Congratulations to the 2013 Managed Care Nurse Leader of the Year!
Sheryl Riley RN, OCN, CMCN!