Case Management Nurse Career Guide

Overview

Case management is a healthcare model designed to coordinate the long-term care of patients suffering from chronic or complicated medical conditions. Because these patients require treatment from various types of health care providers, they need case management nurses (CMNs) who can manage and coordinate their care to ensure they get the care they need from each of their various health care providers, and at the appropriate time.

CMNs are registered nurses who work closely with patients and their loved ones to evaluate the patients’ needs and provide a comprehensive healthcare plan that speaks to the patients’ needs, preferences and goals. The CMN’s primary goal is to ensure that their patients receive treatment at optimal times to ensure they stay healthy enough to remain out of the hospital.

Contemporary case management began in the 1970s, when traditional indemnity insurance plans and federally funded programs lacked incentives for controlling costs, while meanwhile the advancements in medical technology were driving the costs of medical care skyward. The increases in the incidents of chronic illnesses at the time contributed to the problem by complicating the care needed for each patient, leading to both duplications and gaps in patient care. The problems grew with the complexity of modern technology, as the care for patients became increasingly more complicated.

Case management care has addressed these problems by providing a central manager for each patient, improving communication among the various agencies and health care providers. Case management has thus lowered health care costs while providing better patient care.

Some nurses move into a case management position after many years as a regular nurse, due to a desire to work with a specific population and to gain a larger salary. Other nurses become CMNs after completing case management courses.

The nurses who are most apt to thrive in case management are those who are able to see the big picture in terms of the medical needs of each of their patients. CMNs needs to fully understand the medical care delivery system and must take the initiative to pursue the best interests of their clients, while keeping the overall costs of the medical care down.

Job Duties

Most CMNs work with a specific type of patient. Some choose patients with a specific disease, like AIDS, mental illness or cancer, while others choose a specific age group, like geriatric or pediatric patients. Others deal primarily with other types of patients, like those who are awaiting organ transplants.

The particular job skills needed by CMNs depend largely upon their specialization. CMNs who deal primarily with cancer patients might have to coordinate primary care visits, surgery, radiation, and chemotherapy. Those who deal with heart patients might have to coordinate a recovery plan that includes dietician appointments, follow-up surgical visits, medication management and a rehabilitation program.

CMNs sometimes work with patients and their families to help them manage their finances. CMNs often serve as a centralized point of reference for patients and families to get answers to a wide variety of questions. They must also arrange the transfers of patients from one healthcare facility to another.

CMNs need to keep in touch with insurance agencies so that their patients receive proper billed and good rates. CMNs must also keep updated with the latest medical treatments.

Career Outlook

According to the Bureau of Labor Statistics website, job positions for medical and health service managers are expected to grow 22% from 2010 to 2020, which is faster than the national average for job positions. The site also states that the healthcare industry will grow because of the aging of the baby-boomers, necessitating an increasing number of managers in all areas of the industry. This is especially true because of the expected continuation of the trend toward more outpatient care for chronic patients.

Salary Prospects

According to indeed.com, as of 2013, CMNs earn an average of $73,000 per year. These salaries are expected to continue to rise with the increased demand for case managers.

Educational Requirements

CMNs must first become registered nurses, requiring at least a two-year associate’s degree in nursing. Most employers prefer their CMNs to get a bachelor’s or master’s degree in nursing. Other possible degree majors for prospective CMNs are in health services, long-term care administration, public health or business administration. Helpful courses include hospital management, accounting, human resources administration, law and ethics, health information systems and health economics.

Many CMNs work as regular nurses for several years in order to obtain on-the-job training while taking continuing education courses in case management. Some CMNs attend professional conferences and seminars in management to further their abilities.

Campus Type:
Zip:
Matching School Ads
Copyright © 2017 HealthSchoolGuide.net. All Rights Reserved. No part of this web site may be reproduced or transmitted without permission in writing from the publisher. Program outcomes vary according to each institution's curriculum and job opportunities are not guaranteed. This site is for informational purposes and is not a substitute for professional help.