[ryaninmtv]

Hello distinguished colleagues-

I was offered today and accepted a new job within my current organization. Specifically, I am going to be a field case manager working with mostly self-insured employers. My employer is paying to have two lines put into my home (voice and data) and providing me with a laptop computer, a hand-held computer (iPaq)fax/printer, and a cell phone. I will be working from my home (I already have an office in the house) and covering cases mainly within a 100 mile radius of my home.

For the last two years, I have been the supervisor of the self-insured unit supervising a group of 11 telephonic case managers, bill payers, and clerical staff. Candidly, it will be a long time before I take another job managing other people. To say the least, I am burnt out on management. Prior to that I was a telephonic case manager in the self-insured unit and prior to that I was a case manager in the state-fund department (Ohio is a monopolistic state).

I said all of that to say this- I would like input from this distinguished group on what to do, what not to do, any pitfalls you have noticed, or any funny/not so funny tales from your own experience in the field. I am very excited about starting my job (even though I have to wait a few weeks to transfer) but am also a little apprehensive as it will be a new experience. I trust my extended nursing family can walk me through it.

I'm looking forward to your input. Thanks.

[hoolahan]

Congratulations!!!!!!

It sounds like your company a least gives you all the tools you need to be successful. I get no reimbursement for my cell phone, no paynet for phone lines, had my own fax machine, my own laptop, etc... So at least you are treated well, that is a good sign from the start.

WC is interesting. I have learned such interesting things about orthopedics.

I am new to it myself, but I will share anything I can. The only thing that comes to mind right now is, I now treat everyone as if they are guilty until they are proven innocent. I have been made an ass out of so many times by trusting pt's...no more!

Alos, pretend that every phone call to claimant's that you make will be tape-recorded. I have been threatened w that a lot, but it just makes me laugh now!

Get things in writing WHILE YOU ARE IN THE docs office! I fill out a quick note type of form for them, ask then to review what I have written, and sign. then I make their assistant make a xerox for the chart. This way, if the office doesn't already do a quick not, you will have it, and don't have to wait forever, and also, don't always trust docs who dictate in front of you. I have head reports come back that were completely diff from what was dictated or told to me in the office, that is why you should get anything you can in writing before leaving the office!!

Don't abuse your hours. My employer makes us add in things or send lettters that I wouldn't ordinarily send, just for the bill-able time, and it just doesn't sit well with me, that is why I am looking for something else.

That is it. I hope I haven't made it seem negative, it can be a great gig if you don't mind a lot of travel, and your employer is ethical and treats you well.

[renerian]

I work out of my home and sometime my day never ends. That is the only thing I can think of.

Vegas would be a good one to hear from on this.

renerian

[LasVegasRN]

First, congrats Ryan!!!

I can TOTALLY understand wanting to get out of management. I left after 11 years at the same company being the Case Management supervisor over 9 nurses and a case management assistant. My staff was EXCELLENT. Management SUCKED.
If I could have had my staff without all the middle and upper management bull pooky it would have been utopia.

I missed being out in the field. I had forgotten how much I enjoyed working with docs (well, most of them ) and having some patient interaction. In management, I spent 70% of my time in meetings. Meetings about meetings. Meetings to have meetings. Meetings in meetings. Ugh!!

Some pointers:
1. If you have forms that you know the insured needs filled out by the doc, have those forms with you. Get them filled out right then and there.

2. Anticipate. If you know someone is going to have surgery, discuss authorization with the insured. If you have authorizing ability, this will not be an issue. A doc is WAY impressed if they don't have to go through hoops to get an authorization if you can do it right then and there.

3. Know the providers on the self-insured panel. Carry a book with you. Again, anticipate needs. If you have someone with a knee injury having classic popping and clicking, know which MRI facility is near that patient and anticipate the doctor ordering it. Or, go even further - why get an MRI when the doc knows from his exam that an arthroscopy is in order? Go straight for the arthroscopy and save $$$ from doing a test to confirm what he/she already knows.

4. Get a list from your self-insureds on who their VIP's are. Yes, I know we treat all our clients the same and like VIP's, but it's a good thing to KNOW.

5. Do a face-to-face with your self-insured when possible. Even if it's just once. It helps to have a face with a name.

6. Train yourself to have a starting time and stopping time in your home office.

7. ORGANIZE yourself. Keep a rolodex. Don't depend to heavily on your palm and computer. You don't want to be TOTALLY incapacitated in the event of a power outage.

8. Make sure you don't make calls from your personal phone. If you do, make sure your phone number is blocked.

9. If your home address is published in the phone book, make sure you get your number and your home address unlisted. Get a PO Box if you'll be getting correspondence at home instead of the office.

10. Keep copies of your timesheets and expense reports. (I know, that's a no-brainer, but I'm on a roll here )

11. STAY IN TOUCH with your colleagues. Have lunch with them sometimes. You don't want to isolate yourself too much from your peers. It's easy to do when working at home, but interaction is valuable!

That's all I can think of for now. Let us know how it goes!

[ryaninmtv]

Great advice guys! Vegas, I can't agree more about the suckage (yes, that is a word) of management. I have a terrific staff but those above me have no idea what's going on in the trenches. The big thing that made me crazy is getting ripped for other people do. I guess that is the hallmark of management, the buck stops with you but I, for one, am glad ot be on my merry way. Once I get started I'll let you know how it goes. Thanks for the input.

[hoolahan]

Renerian, ITA on the day never ending!!

Vegas makes an EXCELLENT poinbt about face to face w your adjusters.

I did this for a pre-pay situation. The doc wanted the pre-pay before the IME, and the adjusters wanted the IME asap. The docs office agreed to accept a fax of the check, and I agreed to hand deliver it. So, since I literally pass right gy this company on the way to my first appt, I stopped in. They were soooo nice, introdeuced me to all the people I talk with, and it is really nice to have a name w a face. Thy were also very impressed I would do this, little do they know I lived 10 min away too! I have such a wonderful working relationship w them now.

Also, ask how they like to communicate. I have no official e-mail addy for my company, that would mean they'd have to supply us w a laptop, GASP! But I don't mind giving out my personal e-mail to the adjusters, if they like to use e-mail, and most do b/c they can cut n paste my update into their log. It also gets me an answer in writing for auth's which I can print and put in the file. It is important to get things in writing!!!

[linco]

HI!
What kind of job are you doing from home? I have been looking for something to do at home for sometime now as I have fibromyalgia and need something that I can do from my home office. I have 8 years experience in Home Health, some as Case Manager, some as Administrator, I have done some work in clinical MD/NP area, some in the hospital as a float nurse, mostly in orthopedics. I have some insurance experience with Medicare and Medicaid when I was working in Home Health. I am currently working for 3 Assisted Living Facilities. Congradulations on your new position!
Any info would be greatly appreciated.
Sincerely,
Linda RN
Oregon

[ryaninmtv]

Hi Linda-

My job is in workers' compensation as a field case manager. I attend doctor and therapy appointments with my clients. Visit my employers' job sites and manage workers' compensation cases from my home office. Case management is a growing field with a lot of opportunities. Good luck in your search.

[linco]

Thanks for the info, but how do I find out more about this case managment stuff? I used to do case managment in Home Health and have been taking classes for Legal Nurse Consultant from Kaplan Colleges. I know a couple of Worker's Comp attorney's, I would like to put together a case management program packet for them to see if it would be something that they may be interested in. How much do you charge for your services? I would appreciate any info/help you could give me on this.
God be with you!
Linda

[lynnintn]

Linda,
I, too, am a W/C case manager (off and on since 1992).
What Hoolahan and I do is case management for the W/C insurance carrier. Every state is different re: W/C laws, and in some states, such as TN. where I live, case mgmt. is mandatory if the injured worker has been out of work for 8-10 weeks or hospitalized, or if medical costs exceed a certain $ amt.
I have worked for mostly small local companies. Some national companies may train you, such as Crawford, Concentra, or Corvel. Most want to see a ortho, neuro or ICU background.

I just left my very brief stint with a national co. and blissfully returned to my old small comapny, where I work closely with the owners, who are both nurses, and don't feel like a robot who generates billable hours.

Please feel free to email me privately if you have any more questions about w/c case mgmt.

Kim
email: kcwarden@aol.com