What Does a Case Management Nurse Do?

Case management nurses help build consensus between patients, insurance companies, and doctors. Keep reading to find out more about the responsibilities of this profession. Schools offering Nursing Administration degrees can also be found in these popular choices.

Career Overview

According to the Case Management Society of America (CMSA, www.cmsa.org), case management is a multidisciplinary field that involves planning patient care and helping patients communicate with their doctors and insurers. As a case management nurse, you'll expand your role as a registered nurse (RN) and act as a liaison between patients and their healthcare providers. You'll help patients understand the medical bureaucracy and ensure the most efficient and cost-effective treatments are provided to them.

Important Facts About Case Management Nurses

On-the-Job Training Not provided
Key Skills Organization, critical thinking, problem solving, excellent listening and speaking ability, situational awareness, empathy, endurance
Work Environment Hospitals, physicians offices, nursing and residential care facilities
Similar Occupations Licensed practical nurses, primary care registered nurses, utilization review nurses

Typical Job Responsibilities

Your job duties as a case management nurse include identifying patients who need case management services, assessing patient needs, evaluating healthcare plans, and following up on outcomes to ensure patient goals are met. You will also verify insurance or Medicare eligibility, document healthcare decisions made by doctors and patients, and identify community resources for low-income patients. You may be called on to provide treatment advice and lobby insurance companies on behalf of your patients.

Education

To go into the field of case management nursing, you'll first need to become a registered nurse. RNs typically have an associate's or bachelor's degree in nursing. Master's degrees in nursing are available if you want to move into a leadership role or go into advanced practice, such as anesthesia or case management. Case management courses and degree programs can be found in graduate nursing programs. You can either complete a Master of Science in Nursing Case Management or case management nursing continuing education courses.

Certification

The American Nurses Credentialing Center offers a nursing case management certification (www.nursecredentialing.org). The certification program requires knowledge of clinical practice, data and resource management, case management law, and nursing ethics. To be eligible for certification, you must be a licensed RN with at least two years of experience and at least 2,000 hours working in case management. You'll also need to have completed continuing education in the field of case management.

Career Opportunities

According to the CMSA, case management nurses work for hospitals, rehabilitation centers, government offices, and insurance companies. You may also find career opportunities working at geriatric and assisted living facilities, community organizations, and university counseling programs, among others.

Salary Info and Job Outlook

According to PayScale.com, the majority of nurse case managers earn between $50,691 and $85,806 a year, as of September 2015. Although the U.S. Bureau of Labor Statistics (BLS, www.bls.gov) does not provide information specific to the field of nurse case managers, the BLS did project that the employment of registered nurses will likely grow by about 19% between 2012 and 2022.

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