Can anyone give me info about their experiences as a Case Management Nurse?

Specialties Case Management

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I'm very interested in a position as a Case Management Nurse in the near future. Is there anyone who can give me information about their experiences as a Case Management Nurse? Is it true most duties can be performed from home?

Case managers that work from home usually work for an insurance company. Obviously, hospital case managers can't but the core of what they do is same: Assess needs, make a plan, discuss that plan with patient/ care team, and implement . Utilization review is often a major part of case management which involves evaluating the appropriateness of care given against standard criteria. Insurance companies have an "inpatient case management" team and much of what hospital case managers do is feed information to the them. It sounds simple but see my post a couple weeks ago: So you want to be a CM?

Case managers that work from home usually work for an insurance company. Obviously hospital case managers can't but the core of what they do is same: Assess needs, make a plan, discuss that plan with patient/ care team, and implement . Utilization review is often a major part of case management which involves evaluating the appropriateness of care given against standard criteria. Insurance companies have an "inpatient case management" team and much of what hospital case managers do is feed information to the them. It sounds simple but see my post a couple weeks ago: So you want to be a CM?[/quote']

In our state it is illegal for case management to do UR. Third party administrator (TPA) companies sometimes have two separate divisions for UR and CM, but it's a conflict of interest for the CM or the CM department to do UR on his/her/its own patients.

In our state it is illegal for case management to do UR. Third party administrator (TPA) companies sometimes have two separate divisions for UR and CM, but it's a conflict of interest for the CM or the CM department to do UR on his/her/its own patients.

That is very interesting and worthy of new topic.

Specializes in med/surg; corrections;.

It depends on which area you will be working in. I am a case manager for a home healthcare company. I can do a lot of my work from home but I also go into the office everyday to complete paperwork, check my mailbox, check on orders/faxes/etc. I'm sure being a CM for a home health company is extremely different than working in a hospital.

Specializes in Case Management, LTC,Rehab.

i would agree...it depends on what kind of case management you will be doing....when i started out in case management, i was in the public health setting and it required me to be in the field visiting patients, doing assessments, and even giving medications. If i had to do any work at home (which I wouldnt), it would be updated my care plans or typing my assessments. When i transitioned into case management for sub-acute, it was pretty much the same thing. Good luck!

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