What exactly does a case management nurse do?

Specialties Case Management

Published

My cousin just got a job as a case management nurse at an insurance company. I am in nursing school and I want to know what this job entails..How is the pay/benefits...I am going for my associates degree in nursing...Do you have to have a 4 year degreee to do this...

Specializes in Psychiatry, Case Management, also OR/OB.

It depends upon where you are working... CM's work in a variety of locations. Insurance companies, Work Comp, hospitals (acute care), etc. My hospital requires a Master's for us to be CM's. I do dismissal planning, which requires an assessment on the front end of support systems, current equipment owned, where pt lives, if they live alone, etc. I also do concurrent review with 3rd party payors. We chart using computer, with a program purchased by our hospital for CM's only. It has beena blessing and a bane. We also are required to see our patients daily, and document the ongoing dc plan of care. I also provide info to Work Comp providers, and set up OP follow-up such as home health, hospice, or therapies.

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