What is a Nurse Case Manager in the USA?
Nurse case managers are behind every comprehensive health plan. They coordinate patient care, advocate for their patient's well-being, and serve a vital role in any medical facility’s nursing staff.
Being a nurse case manager requires nursing knowledge and administrative skills as a specialty role. These registered nurses do more than treat patients — they organize their overall care plans and ensure that they are given the best care in the most cost-effective, efficient way.
Nurse case managers also help ensure patients are consistent with treatment plans. This part of their job helps improve patient outlooks and reduce the likelihood of return visits or recurrent health conditions.
A nurse case manager can choose any area of specialization they like, pediatric allergies or geriatric diabetes. There is a need and demand for qualified nurse case managers from any age population to virtually any health care domain.
What is the difference between a nurse case manager and a registered nurse (RN)?
Nurse case managers are registered nurses who specialize in managing patients’ care plans. They are patient advocates who coordinate care for their patients rather than provide direct healthcare to various people at once.
The nurse case manager works with patients, their families, caregivers, and doctors to determine the most effective, responsive, and proactive care strategies. Their primary role is to ensure that each patient has access to affordable, effective healthcare.
RNs, on the other hand, work directly with patients to deliver care based on a doctor’s orders. They follow a physician’s care plan and work in a specific healthcare sector. RNs can also work in general hospitals, treating various patients throughout their shifts.
The greatest difference between a nurse case manager and RN is the scope of their work. Case managers focus more on care organization, whereas RNs deliver healthcare directly.
What qualifications does a nurse case manager need?
Nurse case managers must be fully licensed registered nurses with at least one year of clinical nursing experience. Many employers look for candidates who hold a BSN as well.
At a minimum, you will need to be a licensed nurse, have 1 to 3 years of nursing experience, and possibly have a bachelor’s degree.
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What work does a nurse case manager do day to day?
Responsibilities vary for nurse case managers depending on where they work, but their shifts always center around coordinating care for their patients.
On a typical day, you can find a nurse case manager meeting with patients and their families, arranging appointments, calling physicians’ offices, and arranging resources for their patients.
Nurse case managers organize everything in a patient’s care plan, from medication management to nutrition. They may also perform physical examinations, take vitals, and update patient files.
Another interesting aspect of a nurse case manager’s job is financial management. They can reach out to health insurance providers on behalf of their patients to discuss eligibility for different types of health treatments and resources.
Thinking of the 3 As when managing patients’ care can be helpful: achievability, accessibility, and affordability. Nurse case managers ensure all 3 of these requirements are met to promote the best outcomes.
Where do nurse case managers work?
Nurse case managers work in hospitals, nursing homes, rehabilitation centers, psychiatric institutions, physician’s offices, and assisted living facilities. There are many opportunities to customize your work environment as a nurse case manager; choosing where you work also helps you further specialize in serving a particular population.
What is it like to be a nurse case manager?
Nurse case managers are always on-the-go, even when they work in an office-like setting. They have frequent appointments with their patients, meetings with members of their care team, phone calls, and emails to respond to throughout the day.
Being a nurse case manager requires clinical expertise as well as administrative acumen. You’ll need to be able to make each patient feel heard and serve as their advocate when arranging healthcare, speaking with insurance providers, and organizing resources.
If you enjoy nursing, have strong organizational skills, and like helping people make long-term differences in their health, this could be the right path for you.
How much do nurse case managers make?
According to Indeed.com, the average nurse case manager makes $76,903 annually. Salaries in the United States range from $58,306 to $101,432. With 1 to 2 years of experience, most nurse case managers earn approximately $73,910. With 6 to 9 years of experience, the median salary increases to $82,644.
Nurse case managers with more than ten years of experience earn the most, with a median annual salary of $89,582.
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Are there different specialties of nurse case managers?
You bet there are! Nurse case managers have some of the greatest diversity in nursing specialties. Popular focus areas include senior care, diabetes, cardiac care, and addictions and recovery.
An interesting element of nurse case management is the ability to specialize in a patient population or service.
Patient specializations include the types of patients you treat and health conditions you help manage. Service specializations refer to the type of organizations you work with, such as hospitals or nursing homes.
There are also nurse case managers that have duration specialties. They may choose to help patients recovering from short-term or long-term injuries. Each treatment duration poses unique challenges, and specializing in a particular treatment length can help you deliver even more comprehensive care to your patients.
Advantages and disadvantages of a career as a nurse case manager
Becoming a nurse case manager is an excellent way to shape your career, but it does involve a different approach to nursing that isn’t for everyone. To help you better envision yourself in this role, ShiftMed compiled some of the benefits and disadvantages of being a nurse case manager.
Advantages of choosing a career as a nurse case manager
1) Multiple job opportunities
You can work in many different locations as a nurse case manager. Some nurse case managers are in hospitals; others work in long-term rehabs or outpatient care facilities. For as many places there are to work, there are also specializations you can choose to focus on.
2) Less stressful work hours
Nurse case managers tend to work a typical 9-to-5 schedule, so you’ll have greater flexibility and a more regular work schedule than a typical RN. Working standard business hours makes case management a great nursing career for parents.
3) Not as demanding as regular nursing
Because you work in a different context than other RNs, your work is less physically demanding. You still have to be emotionally available to your patients, but you won’t be delivering care in hospital wards or clinics.
You’ll spend most of your time at a desk, so regular stretching and exercise are important. However, fewer physical demands mean a lower risk of work-related injuries, which are common among registered nurses.
4) Work with multiple professionals
You can enjoy connecting with various medical professionals as a nurse case manager. While many nurses often stay connected to other RNs and some physicians, nurse case managers have to coordinate with many types of people. They speak with healthcare professionals, outpatient clinics, physical therapists, social workers, and many other experts to provide care for their patients.
5) Job satisfaction
Seeing your management pay off as patients’ health improve is a wonderful feeling. Nurse case managers coordinate closely with patients, helping them feel heard in healthcare. Often, patients might not know how to advocate for their needs properly; as their case manager, you get to be that voice and help them get the care they deserve.
Disadvantages of choosing a career as a nurse case manager
1) Heavy workload
Many nurse case managers work with patients with complex medical needs and extensive barriers to treatment. You will have to coordinate their care across multiple health disciplines, which can be difficult. There are always calls, messages to respond to, and people to follow up with.
2) Extensive multitasking
If you are not a good multitasker, you may want to reconsider becoming a nurse case manager. You will manage multiple aspects of several patients’ care at any time. You must make routine calls, send emails, and coordinate with different healthcare providers throughout the day.
Someone who is easily overwhelmed may struggle to keep up with the rotational nature of a case manager’s work.
3) Paperwork
As a case manager, you swap patient care for paperwork. You’ll have a seemingly endless list of documents to write and respond to at any given moment. Filling out and submitting various forms will make up a large portion of your job.
4) Emotional burnout
Compassion fatigue commonly affects healthcare workers. Being deeply involved in others’ healthcare can be draining, no matter how much you care. If you want to avoid burnout, plenty of time to rest and rejuvenate is crucial.
How to become a nurse case manager
Begin your journey by first earning an RN license. To become a registered nurse, you must earn an associate’s or bachelor’s degree in nursing (ADN or BSN), then pass the NCLEX exam. The NCLEX is the certifying exam for all United States and Canadian nurses.
Once you’ve passed the exam and gotten your license, start working in a clinical setting you would like to specialize. New nurse grads can often find work on hospital floors and outpatient centers.
You can explore nurse jobs perfect for your skill set and experience through ShiftMed.
With at least one year of experience, you can begin applying for nurse case manager jobs. In reality, many employers look for case managers with at least three years of clinical experience. It will depend on the location and type of patients you will work with.
Frequently asked questions about nurse case managers
How long does it take to become a nurse case manager?
Starting with zero prior experience, it takes 4 to 6 years to become a nurse case manager. You may be able to become one faster if you are already an RN. Completing an RN to BSN program can earn your degree and quickly qualify you to become a case manager.
What is the difference between a nurse manager and a case manager?
Nurse case managers specifically focus on a person’s healthcare plans. Nurse managers oversee a floor or department of nurses during their shifts. While case managers focus solely on patient care, nurse managers deliver care while also managing a staff.
How do I become a good nurse case manager?
Focus on gaining clinical experience first. Being a good RN will help you better understand your patient's needs. Also, ensure you are comfortable taking on a less active role in nursing. You’ll still be busy, but you won’t be providing care the same way other nurses do.
You must also be a strong critical thinker and a good communicator. Nurse case managers have to help make the best decisions for their patients and overcome challenges to care.