What is a Nursing Case Manager?
A nurse case manager is a registered nurse who develops, implements, and reviews healthcare plans for geriatric patients, patients recovering from serious injuries, or those with chronic illnesses. Case managers are an important part of the multidisciplinary team, working in a variety of settings, such as hospitals, medical facilities, a physician’s office, government agencies, outpatient facilities, and insurance providers.
A nurse case manager takes on a key role in every comprehensive health plan you will come across. It is their job to coordinate patient care and advocate for patients. They serve an important role in any medical facilities staff.
These nurses are typically more involved with patients who require chronic or long-term care and those who have complicated medical conditions. However, for a short-term case (such as a patient who overnights for surgery, for example) a nurse case manager may also be involved in their care.
Nurse case managers can specialize in various fields, depending on their training. You may find a case manager working in fields such as:
- Acute care/hospital case management
- Chronic care management
- Geriatric case management
- Palliative/hospice care
- Pediatric or neonatal case management
- Oncology case management
- Rehabilitation and physical therapy case management
- Mental health/psychiatric case management
- Workers’ compensation case management
- Home health case management
- Insurance or utilization review case management
- HIV/AIDS case management
- Cardiac case management
- Transplant case management
The need for nurse case managers is rising in all healthcare sectors. As our patients develop more complicated conditions, nurse case managers are becoming increasingly necessary to make sure that patients receive quality care and positive outcomes.
What Does A Nursing Case Manager Do?
To be a nurse case manager you will need nursing knowledge and administrative skills. Nurse case managers do more than just treat patients, they manage a patient’s overall care plan and make sure that they are given the best, most efficient care.
Coordinate and assess long-term health care of patients
Nurse case managers are responsible for updating patient care plans, performing ongoing assessments of patients, and consulting with clients and their families to establish what medical needs a patient has.
Ensure consistency with treatment plans and monitor follow-up
They help ensure patients follow their treatment plans consistently. This part of their job helps to reduce the likelihood of return visits or recurrent health conditions. Case managers are also responsible for follow-up management. They will monitor a patient’s progress to make sure that the care plan is effective and being followed.
Coordinate care across providers
Nurse case managers are responsible for ensuring that a patient’s care is coordinated across providers and healthcare settings. They may ensure, for example, that once a chronic patient is discharged, they still receive the necessary follow-up at home.
Patient advocacy
A case manager makes sure that patients’ needs and preferences are respected during their care and illness.
Discharge planning
To aid the rest of the team, a nurse case manager will do discharge planning for patients to make sure that they still receive the care they need even once they have left the healthcare facility.
For example, a case manager may coordinate care with a home care physical therapist who can continue to aid in a patient’s physical therapy once they have been discharged or source a well-priced wheelchair for a patient to use when they are home.
Nursing Case Manager vs. Nursing Manager
A case manager is quite different from a nursing manager. A case manager works with patients, their families, caregivers, and doctors to develop strategies for holistic patient care. Their goal is to ensure that each patient has access to affordable, effective healthcare.
Nurse (or ward) managers, on the other hand, are in charge of a specific ward or facility. Their responsibility is to ensure that a ward or facility runs smoothly. They ensure that the ward stock is ordered, and attend to administrative tasks of the ward such as staffing and statistics.
On a side note: a registered nurse works at the bedside to deliver care to patients based on a doctor’s orders. These nurses follow a physician’s care plan and work in a specific healthcare sector.
The greatest difference between a nurse case manager and a nursing manager is the scope of their work. Case managers focus more on care organization, nurse managers focus on the organization and administration of a ward or facility.
How to Become a Nursing Case Manager
Before specializing in any field in nursing you must qualify as a registered nurse (RN) and pass the NCLEX-RN exam. If you would like to become a certified case manager, this is a specialty and the training takes a little longer than RN training. Below, I’ll go over each of these steps in detail.
Educational requirements to become a registered nurse
To become a certified case manager, you will first need to become a nurse. This can be done by either doing an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree. An ADN takes two years to complete, while a BSN takes two to four years, depending on prior experience.
ADN is the minimum required degree to continue to become a certified case manager. While both would allow you to become a nurse case manager, there are more opportunities with the BSN. Because BSN is a higher degree, these nurses have higher earning potential.
Pass the NCLEX-RN exam and obtain state licensure
After completing an ADN or a BSN degree, you will need to take the NCLEX-RN exam. How soon you take the NCLEX exam depends on your state. Generally, graduates take the NCLEX about 45 days after graduating from nursing school. If you are taking the NCLEX-RN exam soon, try Lecturio’s NCLEX practice questions.
Once you have passed your NCLEX exam, you can apply to your state licensing board for your license.
Gaining experience
Now that you’re a registered nurse and you’ve passed the NCLEX-RN and obtained state licensure, you will need to gain some case management experience. Once you are an RN, you are technically qualified to become a case manager. Look for jobs or internships in case management positions.
Experience is so important for developing skills, making sure this career path is the right fit for you, and that you are happy with your career choice. An internship also helps improve your CV and may help you if you would like to apply for specialized training.
Specialized training: nurse case manager certifications
As said before, any RN is technically qualified to become a nursing case manager, but you can also obtain a Professional Certificate. Here are some of the most common certifications:
- The Accredited Case Management (ACM) Certification is a certification that is offered by the American Case Management Association (ACMA). To obtain an AMA certification, you must be a licensed RN, have at least one year of experience in a case management position, and pass an exam that includes questions and simulations.
- A Nursing Case Management Certification (CMGT-BC), is offered by the American Nurses Credentialing Center. This certificate shows that you are competent in case management. To obtain this certificate, you must be a licensed RN, have practiced for two years continuously in the field of page management, have a minimum of 2,000 hours in case management in the past three years, and have completed 30 hours of case management education in the past three years. You will also be required to write an exam to obtain this certification.
Once you have obtained either of these certifications you will be considered a certified case manager (CCM) and this will provide you with more employment opportunities.
Because nurse case managers are required in specialist fields, it’s good to know that if you have another specialty, that may qualify you to become a case manager in that field. For example, if you are a specialized ICU nurse, your ICU certification may make you a good candidate to become a case manager in an ICU setting.
How long does this take?
Becoming a case manager takes about 2–4 years. The exact timeline depends on your degree. Certification requires an additional 1–2 years of work experience, depending on your state.
How Much Does a Nursing Case Manager Make?
According to one website, the average salary of a case manager is $53,426 per year or $25.69 per hour. Alaska has the highest average salary, while Massachusetts has the lowest. Entry-level positions start at about $40,731 a year while most experienced workers make up to $98,597 a year. Remember that this is highly dependent on many factors, including experience and certification.
Conclusion
If bedside nursing isn’t your thing and you feel like you’re admin-strong with management qualities, why not look into becoming a case manager? As I said before, the world of nursing is so vast. There is plenty you can do that’s not just your run-of-the-mill nursing. There is bound to be a career path that will suit your style.
