How Can I Become a Medical Case Manager?

Read to find out how medical case managers work with caregivers and medical personnel to help coordinate a patient's treatment. Learn more about job responsibilities, training requirements, potential employers and certification as well as salary information. Schools offering Health Care Administration degrees can also be found in these popular choices.

Career At a Glance

A medical case manager works with caregivers and medical personnel to help coordinate a patient's treatment and to oversee the total health care experience of that patient. There are two primary pathways to becoming a medical case manager: as a registered nurse (RN) or as a social worker with an emphasis on the medical field.

Registered nurse (RN) case manager Healthcare social worker
Degree Required Associates, bachelor's preferred Bachelor's master's preferred
Education Field of Study Nursing Social work
Training Required Dedicated nursing program Two years of clinical practice
Licensure Required Nursing license Clinical license
Average Salary (2012, 2013) $65,470* $52,520*

Source: *The Bureau of Labor Statistics (BLS).

What Does a Medical Case Manager Do?

As a medical case manager, you would oversee the total health care experience of patients. The elements of a case include diagnosis, assessment, insurance management, treatment analysis and outcome evaluation. You would collaborate with doctors, nurses, patients and caregivers to coordinate the plan of care during a hospital stay. You also might provide psychological and practical support for patients dealing with chronic or acute illnesses as well as terminal diseases.

The case management process includes helping a patient prepare to return home after an extended hospital stay, course of treatment or disability. You also might arrange for home meal delivery and at-home care, transportation for follow-up appointments and long-term care solutions. Additionally, you would maintain knowledge of human services agencies and other organizations that could provide assistance to patients.

How Can I Enter this Profession?

There are two primary pathways to becoming a medical case manager: registered nurse (RN) or social worker. As an RN, you would need to have an associate or bachelor's degree in nursing and be licensed by the state where you work. You might find that most medical case manager positions require a bachelor's degree, and some employers prefer or require a master's degree.

As a social worker, you would be required to hold a bachelor's degree; however, social workers in the medical field often need a master's degree. Social workers can become licensed after two years of clinical practice.

Where Might I Find Employment?

As a medical case manager, you might find employment in a hospital or nursing care facility or with a managed care organization or insurance company. As a social worker who is also a case manager, you might find employment with a family service organization or government human services agency as well.

Can I Earn Professional Recognition?

There are several voluntary certification options available, depending on your place of employment and level of education. For example, you can obtain the Accredited Case Manager designation through the American Case Management Association. This certification is designed for social workers and registered nurses employed at hospitals. The Certified Case Manager designation from the Commission for Case Manager Certification is available to RNs with an associate degree or higher level of education. A licensed RN or someone with a bachelor's degree may become a Certified Disability Management Specialist.

What Salary Can I Expect?

In 2012, the Bureau of Labor Statistics (BLS) reported that all registered nurses, including those performing case management, could expect a median annual salary of $65,470. Job growth is on the rise at 19%, significantly higher than the national average, due to the growing emphasis on preventative and treatment healthcare. The BLS also reported that in 2013 healthcare social workers earned a national average of $52,520.

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