Medicaid case management?

  1. 0
    I'm considering a job as a case manager for a medicaid program. The job sounds similar to home health case manager but without the actual clinical stuff. I have a few reservations so I would love some input

    First- is the focus to cut costs or is it trully patient focused. I say this because years ago I took a job as a case manager for workers comp and it was a terrible experience. I found they really didn't care about the patients or "clients" at all. I quit after 1 month.

    Second- do you miss the clinical aspect? I've been doing home health for so long- I think I might miss the patient teaching/procedures. I sure would not miss on call, weekends, holidays and night-time paperwork.

    I was thinking of trying for the job and doing per diem home visits- but I'm actually relocating to Raleigh, NC in a few months (the job is in Raleigh, NC)
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  3. 3 Comments so far...

  4. 1
    Quote from cocot
    I'm considering a job as a case manager for a medicaid program. The job sounds similar to home health case manager but without the actual clinical stuff. I have a few reservations so I would love some input

    First- is the focus to cut costs or is it trully patient focused. I say this because years ago I took a job as a case manager for workers comp and it was a terrible experience. I found they really didn't care about the patients or "clients" at all. I quit after 1 month.

    Second- do you miss the clinical aspect? I've been doing home health for so long- I think I might miss the patient teaching/procedures. I sure would not miss on call, weekends, holidays and night-time paperwork.

    I was thinking of trying for the job and doing per diem home visits- but I'm actually relocating to Raleigh, NC in a few months (the job is in Raleigh, NC)
    I work for a medicaid program in another state and I would say its a mix of being patient focused and cost saving, but more paitient focused. The number one focus of care plans is "member outcomes" and ways to meet those outcomes while being cost effective.

    I was only doing the clinical aspect for a year after nursing school beforte I took the position but I definitely do not miss it more than I like not having to work weekends or holidays. I do some paperwork at night, but that is because I will go on visits sometimes, finish early and then do charting at home rather than go back to the office and do. I also get to work home some days if I need to (sick kids, need to do care plans without distractions, bad weather etc). Also, although you are not doing hands on skills, you are doing a ton of assessment and teaching.
    MBARNBSN likes this.
  5. 0
    I see it's been awhile since you posted. I did CM for insurance not medicaid but medicaid seems to be more denials and cut throat from what I have heard.
    I am looking into WC and really trying to see if it would be a good fit. Can you let me know the pluses and minuses and what company you worked for that you did not like?
  6. 0
    what are the salaries for such positions?


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