Pros and Cons of Being a Nurse Case Manager
Nurse case managers not only play a role in the treatment and care of patients, but also are an integral part to the functioning of the office administration. Following is a list of some pros and cons that can help you decide if this profession is the best match for you.
| Pros of Being a Nurse Case Manager |
|---|
| High earning potential (top 10% make more than $85,000 a year)* |
| Faster than average job growth expected (19% for RNs and 23% for medical health services managers from 2012-2022)** |
| Can work in a variety of specialties** |
| Often work in comfortable environment** |
| Cons of Being a Nurse Case Manager |
|---|
| Exposure to infectious diseases** |
| May work on-call during odd hours** |
| May work evenings, nights and weekends** |
| Back injuries common from walking and lifting** |
Sources: *PayScale.com, **U.S. Bureau of Labor Statistics
Essential Career Information
Job Overview and Specialties
A nurse case manager is a registered nurse (RN) who has turned toward the administration side of the job. Nurse case managers coordinate healthcare services in an efficient and cost-effective manner for individual patients. In this role, you might develop and monitor treatment plans for acute and non-acute patients from the time they're admitted to the time they're discharged. A treatment plan can include surgery, rehabilitation and post-hospital care.
In this line of work, you would frequently interact with patients and their family members, doctors, clinical social workers, community case managers, rehabilitation therapists and any other persons who can contribute to the continuity of care. You might specialize in an area such as AIDS, rehabilitation or geriatric, pediatric or occupational health.
Job Duties
According to the Journal of the Medical Library Association (JMLA), the five main areas of a nurse case manager's job are assessment, evaluation, planning, implementation and interaction. The JMLA also noted that an important function of a nurse case manager's job is to minimize fragmentation and duplication of healthcare services.
Some specific duties you may have in this position include assessing whether Medicare, managed care or other insurance coverage best suits a patient's needs; communicating with physicians and insurance carriers to request patient referrals and authorizations for medical procedures; consulting with patients and physicians and other healthcare professionals to determine treatment plans; determining insurance eligibility based on diagnosis; monitoring patient progress and coordinating the resources needed for patient discharge and continuing care.
Job Outlook and Salary
According to the BLS, employment for registered nurses was expected to increase by 19% from 2012-2022, while job growth for medical and health services managers was projected to increase by 23%. Some factors contributing to demand in these areas include a growing elderly population and need for more home and assisted-living care as well as a greater need for preventative care services and more managers to oversee healthcare information and staff members. According to PayScale.com, nurse case managers make $65,626 annually on average, while the highest-earning 10% earned more than $85,000.
What Are the Requirements?
You must be an RN to become a nurse case manager, and the BLS reports that a master's degree is often required for management-level nursing positions. Thus, on the undergraduate level, you might want to pursue a Bachelor of Science in Nursing (BSN), which can qualify you for graduate-level programs. You'll also need to pass the National Council License Examination for Registered Nurses (NCLEX-RN) and meet any other RN licensure requirements for your state.
The most common advanced degree programs for this occupation are the Master of Science in Nursing (MSN) with an emphasis in case management and the Master in Healthcare Administration (MHA). Both programs include theoretical and practical application courses to further develop your knowledge of the field. In addition, you should have strong communication, leadership, negotiation and organization skills to be successful in this job.
Job Postings from Real Employers
Most employers looking for nurse case managers require at least two years of case management experience. Some employers also require that candidates have a BSN, and some prefer a relevant master's degree. Additionally, a candidate with applicable certifications is the ideal for some employers. Following are some samples of real job postings for nurse case management positions that can give you an idea of what employers were looking for in March-April 2012:
- A Springfield, MA, nonprofit company looked for a candidate with a current RN license to develop care plans for patients, encourage participation in treatment plans and monitor patients' progress. This employer offered $65,000-$70,000 annually.
- A Phoenix, AZ, health services company sought a candidate with an active RN license to coordinate care for health plan members. This employer preferred those with a bachelor's degree in nursing, a case management certification and at least three years of clinical experience. The qualified candidate would earn $68,000-$73,000 annually.
- A healthcare staffing agency in Chicago, IL, wanted to hire a candidate for placement at a local hospital to manage patient care and discharge services. The posting stated that a candidate must be a licensed RN and have at least two years of experience in case management, discharge planning or utilization management.
- A medical center in San Francisco, CA, was looking for a candidate to manage all aspects of care from pre-admission to discharge for a select group of patients. The posting advertised for a candidate with at least two years of related case management experience and a valid California RN license. This employer preferred a candidate with a master's degree in nursing.
How to Stand Out in the Field
You can distinguish yourself from other candidates by obtaining a professional certification. Becoming certified can show employers that you've met the competency requirements from a nationally-recognized agency in the industry. Some organizations that offer certifications for this profession include the American Case Management Association (ACMA) and the American Nurses Credentialing Center (ANCC).
The ACMA offers the Accredited Case Manager (ACM) designation that's specific to hospital case managers. To qualify for the ACM exam, you must be an RN or social worker with at least two years of hospital case management experience. The ANCC offers the Registered Nurse-Board Certified (RN-BC) case management credential. To take this certification exam, you must be a licensed RN with two years of full-time work experience and at least 2,000 hours of case management work experience and 30 hours of continuing education credits completed within the last three years.
Alternative Career Paths
Clinical Social Work Case Manager
Social workers don't just help clients cope with difficult situations. Those who work in the clinical field can diagnose and treat clients with problems involving behavioral, emotional and mental health. As a clinical social work case manager, you would develop treatment plans for clients and coordinate services that meet plan objectives.
To work as a clinical social worker, you must have a master's degree and be licensed in your designated state, according to the BLS. A Master of Science in Social Work (MSW) is the standard degree for this profession. With this degree, you can provide clinical services in a hospital, mental health, school or other healthcare setting. According to Salary.com, the median wage for a non-RN case manager was $57,000 as of April 2012.
Human Resources Manager
Maybe you like working with people and have good administration skills, but don't want a career involving clinical duties. If so, becoming a human resources manager may be just what you're looking for. In this position, you would be in charge of planning and directing the employee relations functions of a company, such as recruiting, interviewing and training candidates. You would also deal with employee benefits, compensation and leaves of absence.
According to the BLS, you can work in this field with a bachelor's degree. However, completing a master's degree program, such as business administration, human resources management or labor relations, may be required. The BLS reported that, as of May 2011, human resources managers earned a median salary of $99,000.
