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Case Management Nurse: Education and Career Information

Case management nurses are essential in the world of healthcare, as they are qualified in the fields of both nursing and social work. They plan, assess situations and help implement the best care scenarios for patients. Most case management nurses also have graduate-level degrees and are excellent communicators since they are accustomed to working with a host of different individuals.

What Does a Case Management Nurse Do?

A case management nurse is responsible for a number of aspects of client care. He or she is instrumental in coordinating long-term care for his or her patients to keep them healthy, educated and out of the hospital. The case management nurse works to ensure all legal and ethical issues are addressed, and, as clinicians, he or she researches treatments and procedures. This role works collaboratively with both medical and non-medical professionals, such as physicians, nurses, social workers, family members and others. According to the 2010 Role Delineation Study of Nursing Case Management National Survey, some of the main duties of a case management nurse include:

•Documenting clients’ case management plans and on-going activities
•Identifying clients’ insurance coverage or other sources of payment for services
•Identifying and addressing client risk factors and/or obstacles to care
•Identifying client needs, current services and available resources, then connecting the client to services and resources to meet established goals
•Communicating the care preferences of clients, serving as their advocate, and verifying that interventions meet the client’s needs and goals of treatment
•Screening clients and/or population for healthcare needs
•Developing a client-focused case management plan
•Educating the client/family/caregiver about the case management process and evaluating the person’s understanding of the process

How Much Does a Case Management Nurse Earn?

According to Payscale, case management nurses make about $67,000 annually, on average. They can make up to $86,000 or more depending on their level of education, experience and location. The type of work they do and the facility in which they work also makes a difference in salary potential.

What Types of Skills Are Needed to Become a Case Management Nurse?

A number of skills are necessary to become a successful case management nurse:

Project management: A case management nurse must be able to successfully handle clients and all the aspects of their care. This requires a high degree of accountability and project management skills.

Reading comprehension: A case management nurse should be able to read clearly for comprehension and apply the information learned to assist with decision-making.

Critical thinking: A case management nurse must use logic and reasoning to identify areas of strength and weakness, considering alternative solutions and approaches to problems encountered.

Speaking: This job requires speaking with a number of people at different levels. The case management nurse must be able to effectively convey and extract information from a number of individuals in both medical and non-medical roles.

Active learning: Case management nurses must be able to learn different processes, learn their patients and how to effectively deal with a variety of situations.

Observational skills: Study and observation work hand-in-hand. A case management nurse must have excellent observational skills so as to properly assess situations and recommend the best course of action for his or her patients.

Coordination: When studying particular subjects, coordination is key in helping ensure subjects are grouped together to obtain the right information needed.

Management of Personnel Resources: A case management nurse works with others to get the job done. This role must be able to stand as a leader and effectively manage people and resources.

Internship Requirements

Internship requirements vary based on school, state and program. To become certified, a number of clinical and non-clinical hours are required, based on level of education.

Education Requirements

To begin a nursing career, a student must enter into a bachelor’s of science in nursing (BSN) program. This is a four-year commitment that will provide the foundation on which a nurse will advance throughout his or her career. Once this degree has been obtained, sitting for the NCLEX-RN exam to become licensed as an RN is necessary. This foundation will prepare the student to gain experience and further his or her education.

The nurse should then enter into a graduate program to obtain a master of science in nursing degree, or an MSN, with a case management concentration. Obtaining an MBA or Nursing Administration degree is also a consideration, both of which will prepare the nurse to provide clinical management and coordinate care for patients.

The next course of action is to obtain certification in this area. The Case Administrator Management Certificate (CMAC), administered through the Center for Case Management, is specifically designed for nurses who are case management administrators. To become eligible, you must:

•Hold a master’s degree or higher and have 12 months of experience in case management administration
•Hold a bachelor’s degree or higher and have 36 months of experience in case management administration
•Hold a master’s degree or higher and have 36 months of experience working as a case manager
•Hold a bachelor’s degree or higher and have 60 months of experience as a case manager

The exam is very detailed, and it covers a number of areas, including the identification of at-risk populations, assessing components of clinical systems, development of strategies to manage at-risk populations, leadership, HR management, market assessment and strategic planning, and evaluation of programs through outcomes’ management.

A Nursing Case Management Certification is available that awards an RN-BC. The requirements for this exam are:

•An active, current RN license in the U.S. or the equivalent from another country
•The equivalent of two years’ full-time experience as an RN
•At least 2,000 clinical practice hours in case management nursing during the three years immediately prior to applying
•Thirty continuing education hours of case management nursing during the three years immediately prior to applying

Another track allows nurses in this area to become Certified Case Managers (CCM). They must have an active and current RN license, in addition to the following requirements:

•12 months of full-time experience in case management under the supervision of a CCM
•24 months of full-time case management experience without CCM supervision
•12 months of full-time experience as a supervisor of individual providers of case management services

This exam is only offered three times a year, and it must be renewed every five years through continuing education. A number of other case management certifications are available, including the Certified Disability Management Specialist (CDMS), and the Accredited Case Manager (ACM).

This is a very rewarding career for someone who likes to take the initiative and believes in getting the right care for patients. The more education and certifications obtained, the higher the earning potential for this position.

Nursing Scholarships

American Assembly for Men in Nursing (AAMN) American Cancer Society Doctoral Degree Scholarships in Cancer Nursing Gallagher Student Health Careers Scholarship
The Gates Millenium Scholars (GMS) National Black Nurses Association (NBNA) National Student Nurses’ Association (NSNA)
New Careers in Nursing (NCIN) Nurse Corps Scholarship (NCS) Nurses of Tomorrow
Nursing Economics Foundation Tylenol Future Care Scholarship American Holistic Nurses Association
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