How to Become an RN Case Manager

Overview

Case management nurse visiting a patient

RN case managers enjoy both the gratification of patient care and also the rewarding challenge of leadership. From the moment a patient is admitted for care to the time when that patient is released and often even beyond that, the RN case manager plays a fundamental role in making sure that the patient receives the correct care from a team of health care professionals. Case managers must evaluate the patient's health status, facilitate the preparation of a proper plan for care, and then manage the implementation of nursing services in order to meet the patient's individual health needs.

Work Environment

Reflecting the central role that these professionals play in coordinating proper care, RN case managers may be employed by a hospital, nursing facility, insurance company or a home and/or community service group.

If employed at a hospital, the duties and responsibilities of an RN case manager generally include:

  • Medical evaluation of newly admitted patients
  • Involvement in the preparation and implementation of a plan for both in-patient and out-patient care
  • Required communications with a payer or insurance company.

Those RN case managers who work for insurance companies or for a case management company may assume different duties and responsibilities, including the performance of clinical reviews, assisting with discharge planning and designing post-discharge care.

Some RN case managers enjoy responsibility for a large geographic area - in rural parts of the country, for example - and consequently they conduct a significant portion of their duties remotely by phone, but significant travel may be required in order to perform their vital on-site duties as well.

Requirements

Education

An RN case manager is first and foremost a registered nurse (RN). Most case managers have either many years of experience as a nurse or have earned a Master’s in Nursing degree, focusing on a particular nursing specialty. A growing number of these professionals choose to earn a Doctorate (PhD) in Nursing.

The American Association of Colleges of Nursing (AACN) has published a position statement calling a bachelor’s degree a minimum requirement for careers in nursing, which includes case management.

There are essentially three pathways to get the required RN degree:

  • A hospital-based nursing school. These usually take four years to complete.
  • An Associate’s Degree in Nursing. This generally takes two years and is followed by another one to two years for a bachelor’s degree. There may be a few working years between the associate’s degree and the bachelor’s degree, providing a level of flexibility that some candidates find convenient for a variety of reasons both personal and financial.
  • A Bachelor’s Degree (four years) in Nursing (known as a Bachelor of Science in Nursing).

For candidates who have a bachelor's degree in another area, there are also a number of accelerated programs to get an RN degree. Students often complete this process in anywhere from one to three years, depending on the original bachelor’s degree and the specific program.

After receiving an RN (and passing the NCLEX exam), the prospective RN case manager may also seek a Master’s Degree in Nursing (MSN), choosing a particular nursing specialty among the many possible specialties that include the following:

  • Urgent care
  • Geriatrics
  • Pediatric nursing
  • Surgical nursing.

A more complete list of nursing specialties can be found here.

Training

After earning the RN or the MSN degree, the training for case management is “on-the-job.” Additionally, a number of online courses can help to prepare for certification as a case manager.

Licensing and/or Certification

In order to practice as an RN, you must receive licensure by passing the NCLEX certification exam or boards. State requirements vary; consult the National Council of State Boards of Nursing. There are numerous types of board certifications that a prospective case manager can obtain by taking an examination.

The American Case Management Association (ACMA) administers a certification that focuses on hospital case management.

The Commission for Case Manager Certification (CCMC) administers a broader board that applies to both hospital and community case management. This test is given three times a year and certification must be renewed every five years.

The American Nurse Credentialing Center (ANCC) also administers a certification exam.

For a complete listing of organizations offering certification, check out RNCaseManager.com.

Necessary Skills and Qualities

Owing to the multifaceted nature of this position, an RN case manager relies on a variety of skills and strengths in order to thrive. This professional must possess strong analytical and critical thinking skills, as well as attention to detail, in order to evaluate medical conditions and plan for the best care. Being a good listener allows the case manager to better understand both the medical and social needs of patients. RN case managers also rely on solid leadership skills - such as strong oral and written communication, and the ability to manage many professionals - in order to ensure proper care for patients.

If you would like to gain the necessary education to become an RN case manager, we highly recommend that you check out our free School Finder Tool located HERE.

Salary

In 2012, the reported salary range for nurse case managers was $47,830 to $83,370. The median salary was $64,000. This range is based on qualifications (RN, MSN, PhD), location and years of experience. Larger hospitals also tend to award higher salaries.

Job Outlook

There is a predicted shortage for qualified RN case managers. The outlook for growth and prospects in this field is excellent, particularly with the emergence of accountable care organizations (ACOs), which are local, provider-led groups consisting of a diverse range of health care providers collaborating to provide quality, cost-efficient care.

More and more hospitals and community-based care organizations rely upon the specialized RN care manager to utilize resources more efficiently. Certification in case management provides even greater opportunity for those who want to pursue this exciting and important career.

Further Reading

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