Dr. Toni Cesta
Consultant and Owner, Case Management Concepts LLC
Toni G. Cesta, Ph.D., RN, FAAN owns and operates Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating case management models in the acute care, emergency department and outpatient settings. Dr. Cesta writes a monthly column called "Case Management Insider" in the Hospital Case Management newsletter in which she shares insights and information on current issues and trends in case management. Dr. Cesta has held positions as Senior Vice President - Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York where she was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore - Long Island Jewish Health System and Director of Case Management, Saint Vincent's Catholic Medical Centers of New York, in New York City and also designed and implemented a Master's of Nursing in Case Management Program and Post-Master's Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.

The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.
Upcoming Webinar
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Recorded Webinar
Measuring Case Management Outcomes: Does Your Department Make the Grade?
This webinar will discuss and review the expected outcomes of a contemporary case management department. Also included will be a discussion as to how to align these outcomes with the hospital's strategic plan.
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Best Practice Case Management Roles and Functions: How to Optimize RN and Social Worker Skill Sets
Due to the variety of differences in the definition of case management and roles and functions, there is much confusion in the field as to what case management is and how it is applied. Without a national perspective on this issue, many case management departments are not designed to respond to the challenges of health care reform.
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Case Management: Find and Fix Your 2018 Compliance Gaps
By attending this session you will be able to ensure that you understand the compliance issues directly related to the practice of case management and that you have incorporated them into your daily practice. Compliance includes documentation and communication with the patient and family as well. Be sure that your processes are hard-wired and part of your daily routine.
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Interdisciplinary Care Rounds: An Important Tool for Coordinating Care
This webinar will identify the key stakeholders needed for effective interdisciplinary rounds. It will review the best practice rounding processes including scripting and time management. Following this we will discuss how to hardwire your rounding process so that it remains timely and efficient. The roles of each team member will be included as well as how to involve the patient and family in the bedside rounding process. Also important is the documentation of rounds either during or after they occur, so suggestions for effective documentation as well as a template for documentation will be included. Finally, strategies for how to evaluate your rounding process through outcomes metrics will round out this jam-packed program.
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An Update on Discharge Planning Rules and Regulations for 2018
This program will review the current rules and regulations from the Conditions of Participation for discharge planning. We will then discuss the most recent changes from the Medicare program and how they will impact the roles of the RN case manager and the social worker. We will review strategies for safely transitioning your patients across the continuum of care. In addition we will review how to engage other members of the interdisciplinary care team in the process of planning for the patient's movement across the continuum including verbal and written hand-off communication. We will also discuss the positive impact that effective discharge planning processes can have on hospitals, post-acute providers and patients!
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Case Management's Role in Managing Third Party Payer Denials
Case management, as a member of the revenue cycle team, plays a strategic role in the implementation of strategies aimed at reducing and/or preventing third party payer denials. Reducing and preventing denials requires proactive and hard-wired processes that engage the entire interdisciplinary care team. The causes of denials are complex and therefore require complex solutions. This program will review the causes of denials and key strategies for reducing and preventing them. Solutions will include key members of the interdisciplinary care team including physicians, physician advisors, case management leaders and case managers. Strategies for analyzing your denial rate will also be included.
Recorded Session Get life time access for one participant with download option!

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