case mgmt advice

Specialties Case Management

Published

Hi all,

I worked as a case manager in the psych field for about 5 years and enjoyed it. I have a background in social work and during this time I went back to school and got my rn with all intentions of going into medical case management. I knew I needed some bedside experience so I went into a sub acute rehab floor as my first job out of nursing school. I HATED it..... I had ratios of 15 to 20 or more patients and was trained very little. It was so stressful. I lasted 6 months there then went onto an acute rehab floor at a VA. Its been almost a year here now and I'm not loving this job either. I've been stuck on nights with no sight of any day shift options anytime soon. I have a very long commute to work..about an hour which is hard after a 12 hr night shift. I've been crossing my fingers for a cm position within the Va but nothing is coming up. As much as I love the Va and its awesome benefits/retirement .. I think I need to do what I intended which is cm. Sorry for the rant... My questions are:

How different is social work type cm from medical/insurance type cm?

Do big name iinsurance co offer good benefits?

Am I being foolish to leave the Va system?

I know this is hard to answer but seeing as I've been hopping jobs... My biggest fear is that I wont like my next job just because ive been so unhappy in nursing so far...trust me i hate to admit thate..do you think I would like working for an insurance co if I enjoyed doing cm in the past? Any recommendations on where to apply? I'd love to go back into behavioral health. Thank you so much for any input

cephy, RN

8 Posts

Specializes in Infection Prevention& Control, Occupational Health.

Hi ATRN. I am a Nurse Case Manager ( field case manager) for a large insurance company in California; 99.9% of my cases are Workers Compensation. The job is definitely not for everyone- either you love it or you hate it. I happen to love it!

First the pros:

No week-ends; Monday to Friday- 8 hours a day, out in the field attending MD appointments then document/bill from home.

Company car (no car or insurance payments, no maintenance costs).

This one is a biggie- Even when it is really busy, no one is going to die. I paid my dues on med-surg. I did it for the experience only, and hated every short-staffed minute. Staff/clinical nursing was just not for me.

Lastly, I have the most amazing manager- she has my back and all of her team's back. And we are all truly a team!!

Now the cons:

1) Steep learning curve

2) Very steep learning curve ( it bears repeating : ) - A lot of processes and procedures to learn. The first 6-9 months are overwhelming at times.

3) Just my observation, but I think either you have a knack for this kind of case management or you don't. It is hard for me to describe the type of personality that would be suited to this kind of position, but here are some traits that help: An eye for detail, ability to synthesize information, excellent communication skills, ability to balance the sometimes competing interests of the worker, the doctor, the adjuster, and the employer ( the employee doesn't want to work; the ER wants her/him back at work; the doctor believes that the patient has shoulder pain (13 months after surgery) and cannot lift anything ( although she is carrying a large Coach purse filled with 20 lbs of everything but the kitchen sink : )...which brings me to my next point- a sense of humor and patience are a must!!

I hope this helped a little.

I believe my manager may be hiring for a position in Northern CA- the Sacramento area, I think.

Good luck in whatever you decide to do!

atrn4887

21 Posts

Thank for the good insights! Unfortunately I live in upstate NY ;) . I've decided to start looking/applying for case management positions.

rncm2010

7 Posts

I'm an RN, BSN working as a CM in an insurance company. I had 4 years of SNF direct/bedside care when I started in Utilization review for an insurance company. One year later I advanced into CM for the same company. I got an 8 % raise along with the move. So now I am making 70k annually. Our benefits are great: 10 paid holidays, 12 PTO days first year, 15 PTO days second year, etc. Medical/vision/dental covers my whole family (2 adults and up to 4 kids) for $300 out of pocket in premiums per month. We have 401k with matching, flexible spending accounts. I work 4 days per week (10 hr days) and I WORK FROM HOME! Our home office equipment is provided by the company. If I chose to work in the office the location is downtown, gorgeous location and building, but parking costs $200/month. There is a commuter subsidy for people that use public transit. Could it get any better? I wish I was paid more but it isn't bad.

+ Add a Comment