How to become a nurse case manager in the USA?
Nurse case managers handle every step of their patient's care. They ensure that every person gets access to the resources and treatments they deserve based on their conditions, needs, insurance, and budget.
For many patients, accessing the proper care is not always easy. Barriers to treatment can cause preventable illnesses to affect people’s lives, and nurse case managers strive to help people overcome those obstacles.
To become a nurse case manager, you’ll need to build a solid foundation in nursing that prepares you to take on a management role.
What are the steps to becoming a nurse case manager?
You can break down becoming a nurse case manager into a five-step process. Here’s how to become a nurse case manager in five steps.
1. Earn a nursing degree
You have two options when it comes to becoming a nurse: earn an associate’s degree or a bachelor’s degree. Many students wonder what makes the difference between an ADN and vs. BSN. The answer lies in length and focus.
Associate’s degree programs in nursing are shorter than bachelor’s programs. They take around two years to complete, focusing solely on core nursing skills and medical knowledge. Bachelor’s degrees in nursing are longer, lasting four years on average. The time it takes will also depend on whether you attend a full-time or part-time program.
Both degrees expand upon the fundamentals of nursing to incorporate elements of nursing theory, nurse management, and leadership. Managing your time and advocating for proper patient care is critical once you step into this role.
Aspiring nurse case managers will benefit more from the BSN program. You’ll get a more comprehensive education that helps you readily step into more advanced positions after becoming an RN.
2. Pass the NCLEX-RN nursing exam
The NCLEX-RN is the nation’s certifying exam. Anyone who wants to become a nurse has to pass this exam. The NCLEX will test your nursing knowledge across multiple subjects, including
Creating a safe care environment
Management of patient care
Coordinated patient care
Psychosocial integrity
Physiological and pharmacological well-being
Risk identification and reduction
Ongoing health promotion and maintenance
You can read the free NCLEX test plans to develop a study guide.
3. Gain work experience
All nurse case managers must gain experience delivering direct patient care. They can work in hospitals or outpatient settings. What matters most is that you are familiar with the experience of your patients and the healthcare system.
As a nurse case manager, you will need to help people access a variety of treatments. You may specialize in one type of healthcare or a particular branch of medicine. If you are interested in a specialty within case management, look for nursing jobs in these areas, such as substance abuse treatment or pediatrics facilities.
4. Seek a position that focuses on case management
After 1 to 3 years of working as an RN, you can begin to look for nurse case manager positions. There are a variety of jobs ranging from entry-level to senior management. You can build upon your skills and knowledge to begin helping patients in new ways.
As a nurse case manager, you’ll help patients plan their healthcare and connect them to the services they need. You’ll be their first point of contact in many situations to help them receive proper medical treatment.
5. Earn a certification in nurse case management
If you want to deepen your knowledge and become even more qualified as a nurse case manager, you can pursue certification. Certifications prove your commitment to your specialty and can qualify you for more positions and greater job responsibilities.
There are several options for nurse case management certification:
1. CCMC – The Commission for Case Manager Certification
To become a Certified Case Manager (CCM), you’ll need to have an RN, bachelor’s or master’s degree, and at least 12 months of work supervised by a CCM or 24 months of work in case management unsupervised by a CCM. You can also qualify if you have at least 12 months in a supervisory position.
The CCM tests applicants on healthcare delivery, case management concepts, rehabilitation, reimbursement, and psychosocial and physiological aspects of care.
2. ANCC – Nurse Case Manager Certification (CMGT-BC)
This board certification through the American Nurses Credentialing Center demonstrates your entry-level clinical knowledge as a nurse case manager. It can be the perfect stepping stone for an RN that wants to specialize in case management.
The CMGT-BC certification requires a valid RN license, at least two years of experience, and a minimum of 2,000 hours in nurse case management practice within the last three years.
3. ACM - American Case Management Certification
The ACM dates back to 2005, certifying you as a healthcare delivery and transitional care professional. You must be a licensed RN with at least one year, or 2,080 hours, of supervised case management experience.
If you do not have less than two years of experience, you must provide a letter from your supervisor that attests you’ve worked for at least one year in a case management role. As of November 2020, over 7,000 healthcare professionals have earned ACM certification.
6. Apply for nurse case manager jobs
Once you’ve gained experience and certification, you can look for nurse case management jobs in different locations. You could work in a hospital, long-term care facility, rehab, nursing home, or other healthcare facilities. Ultimately, where you choose to work depends on your career goals and the environment you feel most comfortable.
ShiftMed can connect you with the right nurse case management jobs based on your preferences, education, and skill set.
Can you become a nurse case manager online?
You can earn your nursing degree and a nurse case manager certification course online. However, you will need to perform clinical rotations in person to become an RN. You’ll also have to gain experience (approximately 2,000 hours) to earn a nurse case manager certification.
What is the difference between a nurse case manager and a registered nurse?
Nurse case managers and RNs hold the same title and credentials, but a nurse case manager specializes in case management and healthcare delivery. Some have certifications, but others are RNs gaining experience toward a case manager credential.
Case managers tend to focus less on direct patient care and more on healthcare planning and organization. They work with patients to ensure they can access treatment that aligns with their needs and insurance coverages.
They also follow up regularly with patients and doctors to ensure that patients adhere to treatments, attend appointments, and follow physicians’ recommendations. When necessary, they step and offer a helping hand to patients who might not have access to necessary medical resources.
Recommended Reading - What is a Nurse Case Manager in the USA?
What positions can you progress to from being a nurse case manager?
After becoming a nurse case manager, you still have the opportunity to grow in your career. You could earn a master’s degree and become a nurse supervisor, or you may look into becoming a nurse educator.
Experienced nurse case managers may also pursue additional education to become nurse practitioners. Nurse practitioners (NPs) provide direct patient care and can assess, diagnose, and manage their patients.
Do your nurse case manager certificates expire?
Yes, all nurse case manager certifications have to be renewed. You’ll also have to renew your RN license separately from your case management certifications. The expiration dates for case manager certificates vary from 1 to 3 years.
How much do nurse case managers make?
Nurse case manager salaries vary based on education, professional background, and location. According to our research, the average nurse case manager makes $59,493.98 a year, or $28.60 an hour.
Read more about nurse case manager salaries throughout the United States.
How long does it take to become a nurse case manager?
Most nurse case managers spend at least six years becoming qualified. You’ll likely need an associate’s or bachelor’s degree, which takes 2 to 4 years, and 1 to 2 years’ experience in nursing and case management care.
Overall, you can expect to spend around 6 to 7 years becoming a fully certified nurse case manager.
Read our guide on how long it takes to become a nurse case manager.
FAQs about becoming a nurse case manager
Are case managers always nurses?
Most case managers are registered nurses, but some are social workers. Some organizations offer professional case management outside of nursing, but most employers look for candidates with a clinical background.
Is it hard to become a nurse case manager?
Becoming a nurse case manager takes years of dedication, so you must be passionate and committed to achieving your goal. At times, it can be an emotionally draining job, so you will have to be prepared for the risk of stress and burnout.
Gaining a realistic idea of what it’s like to be a nurse case manager can help you decide if this is the right career path.
How do I become a good nurse case manager?
Nursing knowledge is only one part of being a good case manager. You must also be highly organized, empathetic, and outspoken. You advocate for your patient's needs, so you must be comfortable requesting services for them and arranging the care they deserve.
Nurse case managers are strong communicators who coordinate care for their patients across various settings. They speak with doctors, nurses, and insurance companies to get their patients the necessary care.
They also serve as educators, helping patients and their families better understand conditions and healthcare.