Quote from NurseAmie
Why does a CM require an BSN, or even a any RN? Aren't there policies in place that determine the follow through care, and how to arrange it, and who to contact, and what company is in sync/in the program, of any patient based on pay sources, etc? I wouldn't think CM involves much autonomy, so this sounds strange to me. I can't imagine the need for a college degree, really, even, from what I've experienced.
Wow. Are you flipping serious? What an insulting and totally ignorant thing to say.
My company requires BSN, MSN preferred, and a bonus if you have or pass the CCM exam and become Board Certified. Our requirements used to be 2-3 years experience beside AND population/ambulatory care, but we've had to change that. Now we're asking 1 year experience, and the pay and benefits are ABOVE market rates that most bedside nurses get paid, based on credentials and experience. A qualified candidate with CCM cert will start at $50/hr.
Case Management Nursing is serious business that requires a strong background in skilled nursing, good knowledge of CURRENT pharmacology, critical thinking about patients in a holistic approach using the nursing process, ability to navigate insurance companies, policies and laws, and education/experience with patient advocacy/education, social resources and preventative/community health. We will not hire very young and inexperienced nurses. This is an intellectual job that requires maturity and education. It is not clerical. It is not secretarial. It is not for LVNs. It is not technical.
Research has proven many times over that unnecessary hospital admissions and re-admissions drive health care costs up for everyone and contribute to higher mortality rates. Case Management helps prevent that and helps patients with complicated or chronic conditions manage their care.
It's also a relatively new concept and too many agencies and companies have half-baked CM departments that aren't founded on research or EBP. Protocols for CM are still in development with accreditation agencies and insurance companies.
What I do, what we are hiring for, and what many companies will begin requiring are highly educated, well-credentialed, Board Certified, mature, experienced RNs as CMs who can coordinate every aspect of a patient's care and serve as clearinghouse, sentinel and qualified communicator between all elements of a treatment plan. If you know anything about health care, you know that involves insurance companies, UM, teams of doctors, specialists, pharmacies, other nurses, hospital administration, social work, DME, community agencies, municipal services, ombudsman, SNF/LTC, hospices & rehabs, families, DPOAs, POLSTs, lawyers, approvals, denials and appeals, medication assistance programs, home health, other CMs, MAs, TONS of complicated policies and protocols and of course, the patient. The job of the CM is to make sure all these components are talking to each other, understand each other, are within compliance, and following the treatment plan. And an ability to clearly document ALL of it using good writing skills, nursing judgment and proper medical terminology
IT DEFINITELY REQUIRES MUCH MORE THAN A COLLEGE DEGREE.