Managed Healthcare Specialty Certificate -
8 credits

Today’s managed-care environment requires a consultative selling approach that goes beyond safety and efficacy to include economics, total patient care, and quality of outcomes. Representatives who are able to discuss products from these varied perspectives become trusted, valued resources.

CMR Institute’s Specialty Certificate in Managed Care broadens the participant’s understanding of key concepts that have altered the landscape of healthcare delivery—including provider integration, disease management, treatment guidelines, patient-centered care, and pharmacy-benefit management.

Putting this knowledge into practice enables professionals to develop successful field strategies, whether they negotiate buying contracts, interact with Pharmacy and Therapeutic (P & T) Committees, or use pharmacoeconomic analyses and outcomes research to convey value to individual clinicians.

This certificate consists of 31 streamlined online learning modules covering the topics listed below.

Introduction to Managed Healthcare

• The Emergence of Managed Healthcare
• Cost-containment Strategies
• Managed Care and Major Healthcare Payers

The Healthcare Continuum

• Patient Centered Care
• Changing Roles of Hospitals
• Alternative Healthcare Settings
• Current Issues in Managing Healthcare

Issues and Trends in Managed Care

• Evaluating the Quality of Managed Care
• Integrated Delivery Systems
• Disease Management
• Information Technology in Managed Care

Roles of Providers and the Pharmacy in Managed Care

• Healthcare as a Business
• Role of Primary Care Physicians in the 21st Century
• Role of Nonprimary Care Specialists in the 21st Century
• Healthcare Professionals and Managed Care
• Hospitals in the Managed Care Environment
• Ancillary Providers and Managed Care
• The Managed Care Pharmacy

Overview of the Formulary System

• The Formulary
• Formulary Design
• The Pharmacy and Therapeutics Committee
• Criteria for Product Approval to the Formulary

Managing the Pharmacy Benefit

• Strategies for Managing the Pharmacy Benefit
• Role of Physicians and Pharmacists in Managing the Pharmacy Benefit
• Administering the Pharmacy Benefit

Role of the Healthcare Representative

• Trends and Forces in Managed Care
• Trends Among Pharmaceutical Companies (Formulary Related Trends)
• Opportunities for the Healthcare Representative in Managed Care
• Healthcare Representatives and the Formulary
• Responding to Streamlining Strategies
• Adjusting Selling Strategies