Teleohonic "medical case manager."

  1. Hello all. I'm posting this under general nursing instead of Case Management because the position I'm inquiring about isn't really nursing case management. I recently accepted a telephonic medical case management position. I begin my training this coming Monday. The company hires nurses, physicians and CNAs (though I don't know how a CNA can really do this job unless they are in about their last semester if nursing school. ) It's a third party company to an insurance company where we, from what I gather, answer calls from clients seeking health insurance and get an assessment from them about their medical history. From what I'm told, we have to "close cases" as quickly as possible. Our assessments have to be very thorough so that we can "close the case" and not have to keep calling them back to get more info that perhaps we missed. I've read reviews of the company online from previous and current employees. Almost all the comments stated its a high pressure, very micromanaged environment where "you constantly feel like you're going to be fired for making mistakes." I'm the type of person that tries to get ahead and get as much info and advice as possible before I delve into something. So, finally, my question is.... does anybody have any advice on this type of job? How to succeed. What to be prepared for. I've heard there us A LOT of multitasking (but I don't know doing what.) I've heard some clients and physicians can act like real jerks I'm very used to that, so I'm not too concerned about that. But anything else I can prepare myself for? Thanks for reading through this long post.
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    About SleeepyRN

    Joined: Oct '11; Posts: 1,095; Likes: 1,930
    from US


  3. by   nurseprnRN
    Yeah, get another coupla job apps out there. These jobs turn over rapidly for a reason; they really suck the soul right out of you. They track how many calls you make, they keep stats on your "closures," and if you aren't making quota then you work OT without pay (because it's a salaried position, usually) to finish up your calls and complete your computerized documentation. And when you make your quota, they increase it. Sooner or later they make it ridiculously high, you quit, they hire someone else, lather, rinse, repeat.

  4. by   Havin' A Party!
    Hi, Sleeepy. The position you describe doesn't sound like anything I've ever heard of. (And I've worked as a field case manager and a telephonic case manager for an insurance company.)

    Actually, the description seems a little confused. Wonder if you should re-post your question(s) after your first few days of orientation... when things will be a lot clearer to you as to position goals, duties, tasks, etc.

    Good luck!
  5. by   SleeepyRN
    Thanks guys. As far as the job description, I got that from the interview and from 2 of my fellow nursing grads. I graduated a year ago, and one girl has worked there for a year now and says she likes it ok. The other girl no longer works there and says its "HARD" but may be for me if Im used to heavy multitasking with computers, which I am. Honestly, I feel hopeless. I worked for 2 months at a SNF and quit because I let bullying behavior get to me. Then I worked for a few short days until I was threatened to be fired if I made "one more mistake. " The situation was that I got extremely behind on med pass and just had the worst day ever. The DON called me into her office a few days later saying 4 days had gone by without a resident's dressing being changed on her foot. I was the pm nurse who cared for her on the fourth day. (So 11 other shifts went by without it having been changed by other nurses.) It wasnt reported to me that this resident even had a dressing. So I quit because it was very very clear that the DON wanted to fire me but wouldn't yet because she had already promised to give me 1 more day of training (which I had requested after that horrible shift.) My first SNF job was hard but I had been getting better. Slowly. I feel so hopeless. I enjoy nursing but feel like I wasted years because I feel like a failure.
    Last edit by SleeepyRN on Jul 17, '13 : Reason: edit
  6. by   Havin' A Party!
    Have said it multiple times before... nursing is an unbelievably hard gig! In any specialty!

    Newbies need support and guidance. Unfortunately, there's so much to do in the shift that other staff can't devote a lot of time to helping. And management is itself directed to minimize costs (the highest of which is for nursing staff), so they just push new hires along as fast as possible.

    The result is lose / lose: the new hire quits or is fired, and management needs to re-advertise, interview and start the process all over again... costing additional dollars.

    This make any sense to anybody???
  7. by   mlbluvr
    Sad to say, it's true. Where I am, they are now hiring 'case manager extenders', that have no medical or nursing background. They are given a list of clients, and a list of criteria to monitor and a list of ways to avoid paying for their clients hospital stays, etc. It's all totally legal, and legit. Not only are nurses becoming less valuable, but so are case managers, and other health care professionals.