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Managed Care Nurse: Education and Career Information

You have a choice to make. It’s a bit more important than whether you should eat chicken or hamburger tonight or even whether you should attend a private or public college.

You need to decide your future career. It’s a decision that can affect the rest of your working life – or at least until you decide it’s time to choose another career. Of course, you might not want to ever have to make a second career decision. You want to get your first career decision right.

How do you make sure that your first career decision is a great one? Well, there are no guarantees, but what you must do is study, study, and study. Study the careers you’re most interested in so you know what people in that profession do on an everyday basis. Study the steps you need to take to begin and progress in those careers, including the necessary education. And, study the salaries of those careers, including estimates of future salaries that might be based on projected job opportunities.

This report makes your studying easier. It’s about the career, education, and salary of managed care nurses. MedicalandHealthcare.com doesn’t want you to pursue a career for several years only to discover that it’s the wrong career for you. We have studied the profession inside and out so you have enough information to understand the pros and cons of a career in managed care nursing – and we have provided you sources that will furnish you more information.

You still might want to talk to managed care nurses who can give you first-hand accounts of the profession, but this report is based on interviews with managed care nurses as well as sources with detailed knowledge of the profession’s requirements and verifiable statistical data. It answers many questions, including:

What is a Managed Care Nurse?

Nursing is an incredibly diverse profession. Rasmussen College list of 20 different kinds of nurses along with the number of openings, educational requirements, and mean salaries of each kind of nursing. Managed care nurses are not listed, but nurse case managers and nurse supervisors have similar tasks and responsibilities as managed care nurses.

A managed care nurse is a kind of registered nurse. How many kinds of registered nurses are there? Too many to list in one article, says the article “Types of Registered Nurses.” The article doesn’t list managed care nurses either. In fact, the article “20 Types of Nurses Employers Are Looking to Hire” lists 12 kinds of registered nurses, but not managed care nurses.

Because managed care nursing is a specialty of registered nursing, you need to become a registered nurse first. Here is what a managed care nurse is, according to the experts:

•A liaison between “patients, healthcare providers, insurance companies and government organizations,” according to the RegisteredNursing.org report “Managed Care Nurse.” As a liaison, the managed care nurse works with the other entities to formulate a plan that will provide the patients with the best and most cost-effective health care possible.

•A liaison between the aforementioned entities and an educator of patients as well, according to the EveryNurse.org report “Becoming a Managed Care Nurse.” This report emphasizes that managed care nurses often work with low-income people who receive assistance from government programs like Medicaid and Medicare. Thus, keeping costs down is important.

•A liaison/educator who works with patients to make sure they have constant access to quality health care and helps them learn about preventative care, including regular checkups, according to the Johnson & Johnson report “Managed Care Nurse.”

What does a Managed Care Nurse do?

You learned some of the things a managed care nurse does as you read about what it is, but you should know more about what a managed care nurse does on an everyday basis. The list of responsibilities and tasks includes:

•Working with a diverse and often large number of patients.
•Helping devise exercise plans for patients.
•Helping devise nutrition plans for patients.
•Helping formulate medical care plans for patients.
•Working with insurance companies and patients to maximize the chances that the patients’ current insurance plans will cover their medical needs.
•Helping patients find better insurance plans if needed.
•Finding the right doctors for each patient.
•Making sure that patients don’t undergo unnecessary medical procedures.
•Reviewing patients’ medical histories so the best plans moving forward are formulated.
•Interviewing doctors so the best plans moving forward are formulated.
•Making sure that patients follow doctors’ instructions and medical plans, including checkups, immunizations, screenings for specific issues, and vaccinations.

What Skills does a Managed Care Nurse need?

Part of the answer to the above question is technical skills that managed care nurses will learn as they are educated in nursing. The details about education are addressed in a later section. This section addresses the non-technical skills managed care nurses need so you can assess whether your personal characteristics are a match for the profession.

The skills needed include:

Interviewing skills: Managed care nurses must be able to ask doctors, hospitals, insurance companies, and patients the right questions so they get the right information – and understand when they have all the information they need.

Compassion: Managed care nurses must care enough about their patients to maximize the chances they will get the best possible care. Thus, they must have the patience to listen regardless of how time-consuming and psychologically stressful listening is.

Communication skills: Speaking and writing clearly is crucial. You can’t communicate a detailed exercise plan or nutrition plan or medical care plan only orally. Organizing the plan on paper and presenting an easy-to-read plan to patients will improve the chances it is followed.

Computer skills: Knowing how to research information about medical care and insurance plans is important. So is making sure that complete and updated records are kept on a computer system.

Managerial skills: If you become a managed care nurse, you will need to do more than follow instructions. You will be managing several patients’ medical care as if you were managing several employees. Managers need to simultaneously have the interpersonal skills to motivate patients and an authoritative manner when it’s required.

Calm temperament: Managed care nurses often work in hospitals, specialty clinics, and community health centers. The environment is often hectic and hustle-bustle. They need to manage their frustrations and keep their composure.

What Education does a Managed Care Nurse need?

As mentioned earlier, a managed care nurse is one of many registered nurse specialties. Consequently, you need to become a registered nurse first. The first requirement to becoming a registered nurse is earning a nursing degree. You can either earn a Bachelor of Science in Nursing (BSN) or an associate’s degree in Nursing. Generally, it takes two to three years to earn an associate’s degree and three to four years to earn a bachelor’s degree.

After earning your nursing degree, you need to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a registered nurse. At this point, a prospective managed care nurse should work as a registered nurse. In the meantime, continuing education courses in subjects like managed care and social work are recommended. You could also prepare for a managed care nurse career by taking these subjects as an elective while you were an undergraduate.

The next step is getting certified as a managed care nurse. The American Association of Managed Care Nurses requires a registered nurse license, three to five years of clinical experience as a nurse and a home-study program that includes courses in healthcare management and patient issues. The American Board of Managed Care Nursing also offers a certification. This certification is not required, but is a competitive advantage for managed care nursing applicants, according to the “Managed Care Nurse” report.

Post-graduate work is not required, but a Master’s of Science in Nursing (MSN) could be beneficial for prospective managed care nurses interested in management jobs.

How much do Managed Care Nurses earn?

Now that you know everything about what managed care nurses do, what skills they need, and what courses they need to take, it’s time to tell you what MedicalandHealthcare.com knows about managed care nurses’ salaries.

The U.S. Department of Labor’s Bureau of Labor Statistics (BLS) has a lot of information on the salaries of registered nurses. Remember, managed care nurses are one of many specialties of registered nurses. A May 2016 BLS report entitled “National Occupational Employment and Wage Estimates” says that registered nurses have an average annual salary of $72,190.

Of course, salaries are partly dependent on location. Registered nurses in California ($101,750), Massachusetts ($89,060), Hawaii, Oregon, and Alaska are the best paid, according to the report.

The BLS also has information on the future job prospects of the profession. The number of jobs in the profession is projected to grow 16 percent until 2024. That is a “much faster” growth rate than average, says this report. Altogether, there will be almost 3.2 million nursing jobs in 2024, an increase of almost 450,000 from 2014.

The “20 Types of Nurses Employers Are Looking to Hire” article also has info on job openings and salaries. It reports that registered nurses have an average annual salary of $68,164 while nurse case managers and nurse supervisors have average salaries of $70,716 and $65,744 respectively.

Conclusion

Managed care nursing isn’t the right profession for everyone, but it might be the right profession for you depending on your personal characteristics, whether you are willing to spend years in educational and clinical settings to become an excellent managed care nurse, and your objectives in regards to wages and quality of life.

There are many other sources that can help you learn more about the profession, which includes:

The American Association of Managed Care Nurses
The American Journal of Managed Care
The American Board of Managed Care Nursing
Managed Care Magazine

Nursing Scholarships

American Assembly for Men in Nursing (AAMN) American Cancer Society Doctoral Degree Scholarships in Cancer Nursing The Gates Millenium Scholars (GMS) 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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