How to Become a Case Management Nurse [2023 Guide]

What is a Case Management Nurse?

A case management nurse helps plan, create and manage the treatment plan of a patient, in collaboration with doctors, in order to provide the best level of care for that individual. A medical care plan takes into account the needs and desires of the patient and their loved ones, the patient’s prognosis and medical history, their risk factors for other illnesses, their health insurance and the specific malady for which they are seeking treatment.

Case management nurses tend to work with patients needing long term care. You may be working with patients with cancer, Alzheimer’s, heart disease, diabetes, physical disabilities and mental health issues.

What Does a Case Management Nurse Do?

Working as part of a medical care team, which includes medical physicians, the case management nurse helps to devise a care plan which is tailor made for the individual. Usually patients with complicated or long-term illness or injuries will need the support of a case management nurse. The case management nurse has to keep the best interests of the client in mind at all times, whilst working within the limits of the medical establishment.

The case management nurse will consider patients’ needs such as their non-medical timetable, their transportation or lack thereof, and juggling family commitments. By tailoring the plan to the individual and taking into account their lives outside of the medical establishment, the success of the patient’s treatment is greatly enhanced.

The case management nurse will keep the patient advised of any information that they should be aware of, such as new treatments or additional resources that might benefit the patient in their recovery. Offering information and choices to the patient allows them to be proactive in their treatment and healing and leads to a greater chance of success.

Related Reading: Acute Care Nurse Practitioner Careers

The case management nurse remains supportive of the patient throughout the length of their treatment. The case management build up trust and rapport with the patient and becomes a stable and consistent figure the patient can rely upon as they go through their treatment.

The case management nurse along with the team, will regularly update the plan as necessary. If there are changes in the patient’s condition for example, the care plan must be changed to reflect the necessary changes in ongoing care.

One of your goals as a case management nurse is to support your patients when they are healthy, to remain healthy and stay out of the hospital as long as possible.

Where Does a Case Management Nurse Work?

A case management nurse may work in a variety of different places: A hospital, a nursing home, a hospice or a rehabilitation center. You may be working in a clinic or in a private practice.

You could be working for a home healthcare company, where you would be overseeing the care plan for the patient which would allow them to remain in their own home.

You could be working in a research facility managing cases for those who are participating in clinical trials. Another possible work place could be an insurance company. A case management nurse may also work independently as a contractor and assist clients privately.

What are the Requirements to Become a Case Management Nurse?

One of the primary advantages of a career as a case management nurse is that there are multiple pathways to finding employment in this field of work. This includes varying means by which you can fulfill basic educational requirements for entry-level positions, as outlined below.

Educational Requirements

At a minimum, you must have a bachelor’s degree in nursing to become a case management nurse. Nursing degrees can be completed in a wide variety of educational environments, from community colleges to universities and even to online programs in nursing.

For students that are already a registered nurse (RN), but with an associate’s degree, there are options for continuing their education to complete a Bachelor of Science in Nursing degree, or BSN. These RN-to-BSN programs are highly popular for nurses that want to build on their education and work experience, and typically take two to three years to complete.

Students that are pursuing a BSN have four years of studies to look forward to. These programs, like the RN-to-BSN program discussed above, focus on developing the knowledge and skills required to practice as a nurse. This includes coursework in anatomy, physiology, biology, pharmacology, nursing practice, and concepts in nursing, to name a few.

Though it’s not always required, some case management nursing positions require applicants to have a master’s degree in nursing (MSN) or higher. A master’s degree in this field takes about two additional years to complete after a BSN is obtained. These programs are much more focused on practical application of knowledge and skills than undergraduate programs.

For example, where a student in a BSN degree program might take a course on psychiatric nursing, a student in a MSN program would likely work directly with psychiatric patients as part of a practicum experience, or at the very least observe how nurses work with psychiatric patients in an inpatient facility.

Licensure

Licensure for case management nurses is mandatory comes in the form of the Registered Nurse designation. An RN is bestowed upon a student that has completed two tasks: First, graduating from nursing school, and second, passing the licensure exam for RNs administered by the National Council of State Boards of Nursing.

Certification

Certification for case management nurses is not always required, but employers view it very favorably. Certification usually requires some combination of hands-on training, classroom learning, and clinical experience. Additionally, a certification exam must be passed with a satisfactory score. Certification for case management nurses can be obtained from the American Nurses Credentialing Center or the American Case Management Association.

What Do You Learn in a Case Management Nursing Degree?

Common coursework in a case management nursing degree includes:

Anatomy – Students learn about the structure of various systems in the body, like the respiratory system, in both classroom and laboratory settings.

Physiology – Coursework in physiology focuses on how cells and organs within a specific system function. For example, students explore the functions of the heart as it pertains to the cardiovascular system.

Microbiology – Microbiology is the study of very small living things, like microbes and bacteria, and more specifically, how they interact with the human body and benefit (or harm) our well-being.

Chemistry – Chemistry is the study of matter. As it pertains to nursing, students must have a deep understanding of how substances interact with one another and how they might impact the patient’s health.

Pharmacology – Prospective nurses must learn about common drugs used in healthcare settings, including their effects, side effects, uses, and calculating dosages.

Psychology – Not only is the study of human behavior important for nurses to be able to recognize certain mental or behavioral conditions in patients, but it’s also important to study given the stressful nature of this kind of work.

Nutrition – Basic coursework in nutrition is often part of a case management nursing degree so students are equipped to follow doctor’s orders regarding a patient’s nutrition. For example, if a patient can only have clear liquids as part of their diet, nurses must follow those orders and understand why such orders are in place.

Nursing theory – Nursing students must have a solid base of knowledge regarding current practices in the field of nursing and case management. Nursing theory helps define and organize information so that nurses can approach each situation by analyzing the available information.

Nursing practice – Case management nurses must have the hard and soft skills needed to interact with patients, assess situations quickly, make snap decisions, and have good bedside manner.

What are Advantages of an Online Degree in Case Management Nursing?

Students that pursue an online degree in case management nursing might reap the following benefits:

Fewer opportunity costs – Since online learning can be done from home, students don’t have to worry about the opportunity costs of attending classes on campus, like time in traffic, parking fees, and so forth.

Wider selection of courses – Many online degree programs in case management nursing offer expanded course offerings that might not otherwise be available in a traditional on-campus program.

Learn at your own pace – Some online degree programs allow students to be much more self-paced in their learning, which can be beneficial for students that need additional time on certain concepts or less time on concepts that they already grasp.

Learn from home – Many students have other obligations (i.e., children, elderly parents) that require their attention. Online learning is often the ideal solution for students that need to be at home to tend such important tasks.

Access to online learning materials – Be it a podcast, a video recording of a lecture, or a transcript of a class discussion, learning in an online degree program gives you a wealth of learning materials to help you master the material.

Easier continuing education – Students that already work full-time will have an easier time pursuing an online degree program because of the flexibility they offer.

What Skills are Required for a Case Management Nurse?

Multi-Tasking

The case management nurse must be able to perform multiple tasks, from connecting with and supporting the patient and their family, to coordinating group meetings, acting as a secretary to doctors, consultants and clinicians, managing implementation of procedures, monitoring medications, liaising with community resources, and connecting the client to them as necessary, conducting satisfaction surveys, and so on.

Excellent Interpersonal Skills

The case management nurse must be able to create a sense of trust, rapport and safety for the patient and their family. The case manager must be able to work with a variety of different personnel in a warm and efficient manner.

Great Communication Skills

The case management nurse should be able to communicate effectively at many different levels. The case management nurse will need to impart information to the patient and the patient’s family in a way that they can understand. The case management nurse also has to communicate with medical professionals and keep communication flowing and open.

Organizational Skills

Because of the multiple tasks necessary for this role the case management nurse will need to be well organized and efficient. Case notes and reports will need to be kept up to date and modified on an ongoing basis. Team meetings will need to be organized and invites sent out. The case management nurse will be scheduling appointments and procedures and ensuring that they are carried out.

Management Skills

The case management nurse will be responsible for leading the team assigned to a patient’s care. He or she will need to organize meetings, ensure everybody gets there, collaborate with the team and the patient and their family, as well as community agencies and bodies. The case manager will ensure that the best care is delivered to the patient based upon their specific needs.

Scheduling Skills

The case management nurse will be responsible for scheduling meetings, appointments, counseling sessions and contact with outside agencies.

Monitoring Skills

A case management nurse will keep monitoring a patient’s medications and will administer them and make adjustments in consultation with the medical team as the patient’s needs change over the course of the treatment.

Coordination Skills

Keeping everybody involved in the loop as to what is happening or needs to happen is part of the role of the case manager. The case management nurse needs to keep information flowing and oversees the smooth running of the process of care delivery.

Team Player

The case manager needs to be a good team player, able to cooperate with others, communicate effectively, collaborate, work together and be flexible. The case manager needs to be able to maintain good relations with others, must be a people person and enjoy working with others.

Report Writing Skills

The case management nurse will be writing reports on the patient’s care plan and the patient’s progress, updating records as required, as the patient’s medical needs change over time.

What are the Pros of Being a Case Management Nurse?

Good Pay: Although the pay varies, you have the opportunity to make a good income as a case management nurse.
Room For Professional Growth: You need a broad variety of skills and qualities to be a case management nurse and there is plenty of scope for professional development within the role.
Autonomy In Your Role: You will be able to take a leadership role and you will be self-reliant. In collaboration with others you are able to make decisions and the coordination, planning and scheduling is all down to you. This gives you a lot of freedom that you might not get in some other positions.
Make A Positive Difference: You will be making a real difference in the lives of your patients. By considering their needs and making the care plan patient-centered, by supporting them to be engaged and involved in the treatment plan and outcomes, you are a positive force for healing and successful treatment.
High Level Of Responsibility: As a case management nurse, you will have a lot of responsibility on your shoulders. This can be very rewarding.
Job Satisfaction: Because you are truly helping patients to receive the highest level of care, based on team work and collaboration, the potential for job satisfaction is very high. You can really feel fulfilled in his position.
Empowering Patients: Part of your role will be to empower patients by educating them and giving them access to information so that they can make informed decisions and feel engaged in the process of getting well.

How Much Does a Case Management Nurse Make?

As of December 2022, ZipRecruiter reports that the average annual salary for case management nurses is $74,103 per year. That figure is commensurate with nurses that have several years of experience working in this field.

Entry-level positions as a case management nurse will likely garner an annual salary that’s closer to $55,000 per year. Conversely, nurses in this field that have upwards of 10-15 years of experience might expect a salary closer to the $100,000 mark. Naturally, one’s level of education (i.e., a bachelor’s degree or a master’s degree) influences the salary that’s earned.

The largest hospitals tend to offer the highest salaries. If you need to travel a lot, for example to meet with patients, then you may command a higher salary. The more experience you have, and the higher your level of education, then the higher your salary will be. Geographical location is also a factor which affects salary.

What is the Job Outlook for Case Management Nurses?

According to the Bureau of Labor Statistics, the job outlook for nursing as a whole is quite good. As of 2021, the BLS predicted that the field of nursing would grow at a rate of 6 percent between 2021 and 2031, which is much higher than average.

Case management nurses, in particular, should expect to be in high demand in the coming years. With more and more inpatient services now being offered on an outpatient basis, the need for qualified case management nurses to coordinate care for patients in non-hospital environments (i.e., the patient’s home or at a rehabilitation center) is very high.

What Careers are Similar to Case Management Nursing?

Registered Nurse: You will be supporting patients across the spectrum of disease, and demographics from young to old. You may be educating patients and their families or specializing in a particular area of medical care. You could become a trauma nurse, a pediatric nurse, a geriatric nurse or a psychiatric nurse.
Military Nurse: Military nurses hold military rank. You will be nursing military personnel and may be in dangerous situations. This can be very stressful. You will be able to travel the world, and there are a number of benefits which come with being a military nurse, such as an excellent education and good compensation.
Nurse Midwife: A very rewarding career where you will be privileged to witness the very start of life for the babies you will be delivering. You will care for expectant mothers, their unborn babies and their newborns. You will need to be prepared for medical emergencies and the unexpected.
Research Nurse: As a research nurse you would be working in the field of pharmaceuticals to help improve and perfect medications. You might be researching diseases or assisting in or overseeing clinical trials. You might be required to observe patients or study previous findings.