Question;WEEK 3Utilization Management (graded)What are the primary categories of utilization management (UM)? How does UM determine medical necessity through the use of evidence-based guidelines?Case Management Versus Disease Management (graded)What are the key differences between conventional case management and disease management? Provide some examples of diseases that seem to benefit from a disease management model of care.WEEK 4Managed Care Pharmacy Benefits (graded)What are the most important elements of a managed care pharmacy benefit program? And how are patient prescription benefits typically different under managed care?Managed Behavioral Healthcare (graded)What factors surrounding behavioral health create special challenges and special considerations for managed care programs? How is managed behavioral healthcare different from managed acute medical or managed acute surgical care?
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