The most common perception of a nurse likely is the professional caretaker working in a hospital, handling several patients at once, making rounds to gather vitals and usually never seeing those patients again once they are discharged.
Like those professionals, case management nurses are RNs (registered nurses). Their day-to-day duties, though, are quite different. A case management nurse coordinates all aspects of a patient’s care, and the nurse’s relationship with the patient may extend well beyond the hospital stay.
Case management nurses might work at hospitals, but also can be employed by other care facilities, insurance agencies or a dedicated care management company.
Case management nurses coordinate all aspects of a patient’s care, from the time that patient’s treatment begins until his or her discharge, and often well after that.
Other duties may include:
- Planning and implementing patient care
- Evaluating patient care
- Monitoring quality of provided care to ensure infection control, risk management, and other services
- Facilitating patient priorities while working with an organization’s regulations
- Working with other care professionals to devise a care plan based on patient needs, history and medical problems
Their patients might be accident victims in hospitals, terminally ill in hospice care or residents of nursing homes or assisted living facilities. Patients might be dealing with mental health issues or addiction, abuse or neglect. Whatever the situation, a case management nurse oversees the patient’s care, but must balance many factors in doing so.
Case management nurses work with physicians, other nurses, social workers and other professionals in and out of the medical field, particularly with insurance companies and government agencies that facilitate payments for healthcare.
It’s challenging work, as case management nurses must address and work for the patient’s best interests, taking into account the patient’s physical, social, legal, financial and emotional needs.
How to Become a Case Management Nurse
Becoming an RN is a prerequisite to becoming a case management nurse. Earning a bachelor’s in nursing or other advanced nursing degree is common, although some case management nurses hold diplomas or associate degrees.
Necessary skills are oral and written communication, problem-solving and conflict resolution, along with being computer literate, organized and able to perform research. As with most nursing specialties, experience as an RN is valuable for this position.
Certification is available through the Commission for Case Manager Certification.
Job Salary and Outlook
The U.S. Bureau of Labor Statistics Occupational Employment and Wages data for May 2016 listed the average salary of medical and health services managers as $109,370. The middle 50% earned a range of $73,710 to $127,030. Salaries can vary widely depending on geographic location, educational level and other factors. Job seekers should do their own research to find salary information pertaining to their particular job search. The BLS predicts this field will grow by 17% from 2014-2024.
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