Breaking into Case Management

  1. There was a question asked, "how do I get an employer to look at me for a case management position?". If you haven't done case management before and are looking to get in, I have a few pointers.

    When I used to interview nurses who were interested in getting into case management for the first time, there where quite a few things I needed to feel comfortable with in order to give them consideration (not listed in order of importance). Please feel free to add to this post if anyone else has things they look for also.

    1. The ability to use a computer - essential in the setting I worked in. 98% of our work was entered into a program. It was also essential that they knew the basics of maneuvering in Windows and operating systems.

    2. The ability to show creative thinking - during the interview, I would give case scenarios. There were no specific answers I was looking for, I wanted to see what their thought process was: how they set priorities, what was of most importance, what things they focused on.
    Here's an example of one of my case scenarios (I used to give 5 or 6):
    You have a 16 year old illegal immigrant who has just lost 3 fingers on his dominant hand. After completion of the surgery to try and reattach the fingers, we find out he is a diabetic - previously untreated. What would be you main concerns as his newly assigned case manager?

    3. Background - I liked my case managers to have background in home health and some utilization review. Psych was a plus, as that can be a major component in case management. They had to have at least 5 years med-surg experience.

    4. Communication skills - I looked at how they presented themselves at the interview. Did they communicate their thoughts clearly? How was their attitude during the interview? Did they seem confident?

    5. Question answering - I didn't ask the "tell me your strengths and weaknesses" questions. Those didn't do anything for me. I'd ask "Tell me about a time where you had a disagreement with a physician. What did you do to resolve the situation?"..."Tell me about a time where you had a non-compliant patient. How did you handle the situation and what did you do to resolve it?"..."Describe to me what traits a good case manager should have in order to get positive outcomes"...

    Those are the points I can think of that were important to me as a supervisor looking to hire a new case manager who did not have previous experience.
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  2. 25 Comments

  3. by   caliotter3
    Hey LVRN

    Thanks for the thread. Just what I need. Down the road I would like to consider case mgmt and would like to prepare. Are there any educational requirements or programs to help? Just got an ad for a one day seminar which I'm going to go to just to see what it's like.
  4. by   baseline
    Very good advice! I am relatively new to hospital case management but with 30 years of nursing under my (seemingly continually expanding ) belt. Case management uses all the skills I used in ED, Quality Management, Risk Management, CCU and management. A good sense of humor is helpful as well as a strong self image. Good thread!
  5. by   LasVegasRN
    So true, baseline. You can see by my behavior on this board a sense of humor is mandatory! :chuckle

    Caliotter - You might want to start with some of the recommended reading by the national CCM board. Some of the other threads in this forum have sites listed and reading material case manager's found helpful. I find that you can attend classes, but the actual hands-on application comes as you go. Every one develops their own style. The key is fine-tuning your ability to problem solve in different situations.

    An example, just off the top of my head: You have a 55 year old male, Type A personality who just had a triple bypass, poor health. He didn't do well post-op CABG. He no longer meets acute care criteria but is only able to ambulate 25 feet with a front-wheeled walker and minimal assist. His O2 Sat on room air is 84%, after he ambulates his O2 Sat is 75%. He lives alone and only has 5 skilled nursing days covered under his insurance per year. What would you do with this gentleman in order to maximize his recovery under the confines of his insurance? Where do you start? What are your initial concerns?

    That's the kind of issues a case manager has to deal with constantly, in all different kinds of settings. I have to admit, workers compensation is a little easier because your not working under plan limitations as you do under group health insurance.
  6. by   caliotter3
    Thanks again LVRN, you've given me an idea of what to look for and think about. I can see that I have a long way to go!
  7. by   renerian
    I feel much better now after my Friday interview after reading your thread. I have been in home health 11 years, acute care on a BMT unit 6.5 years and LTC/SNF 3 years. I have worked in management including case management in home health for the entire 11 years. I informed the interveiwer if they required certification I would be happy to do that after I learned about the test and what I would need to study.

    Thanks for posting this thread.

    Wish me luck,

    renerian
  8. by   renerian
    Vegas I am supposed to hear this afternoon whether or not I got the case management job...............crossing fingers big time......

    renerian
  9. by   LasVegasRN
    Good luck!!
  10. by   renerian
    Thanks Vegas. I am hoping to hear from them soon..................crossing fingers.

    renerian
  11. by   SHELLYBELLYRN
    OOOO......I'm dying to hear about your potential new job, renerian................let us know as soon as you know!!!!
  12. by   renerian
    Thanks Shelly. I called the manager around 5:15p and she said they were still deciding and they would call me tonight. Hard waiting.....

    renerian
  13. by   ryaninmtv
    Renerian, I see you're in Ohio. Lots of demand for case managers here.

    When I'm interviewing a case manager, the main thing I look for is how does this person communicate. To the case manager, this is as important as IV skills are to the ICU nurse. Like Vegas said, you have to learn to think outside of the box. Many times the situations you encounter defy any "clinical pathway" that you may see in a textbook. In my particular area (workers' comp), you get to add all of the lovely legal contentiousness. Again, case management is not for the weak but if you love it (and I do), you'll never want for a job.

    Good Luck with the job. Keep us posted.
  14. by   LasVegasRN
    Originally posted by ryaninmtv
    Renerian, I see you're in Ohio. Lots of demand for case managers here.
    No wonder my Dad keeps asking me about moving back there. I should pull up the Plain Dealer and Toledo Blade classifieds just to see what's out there...

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