Advice needed, please!!!!!!

kellenl · Apr 4, 2012

I would ask what is the case load and what will your job entail. Especially since you are a new grad with no experience. At my facility the "newbies" with no CM experience start out in precert and QA for the first 1-3 years. Case management can include PA, QA, Utilization Review, Audits, Appeals, patient liason.

angel337, MSN, RN · Apr 5, 2012

case management requires that you can use your nursing experience and assessment skills to provide the best resources and information possible to a population. I would be a little skeptical about a company that seems so desperate, especially considering your new grad status. I wish you the best though and you afre right on target trying to get hands on patient experience first.

**NickiLaughs, ADN, BSN, RN** · Apr 6, 2012

It kinda depends on your LVN background, if it's enough. But I would think you'd almost have to go in and try and see if you can handle it. I just started in CM doing a little bit of everything for an insurance company. I've got three years ICU and 3 years as an LVN in a variety of backgrounds. It was more than enough for me to handle it.

Mijourney · Apr 7, 2012

I think that it would be important to have certain types of experience as a RN. Your LPN experience may or may not be helpful. If you like psych then I would try to work in that area as an RN first before I took on the responsibility of going into any kind of case management. Psych is not medical and since that is your passion, I would go for that as diligently as I could. If you are going to start off in an administrative area, however, I would personally like to see you in UM or UR first. You would be more effective and experience less frustration as a CM after you work those areas. Also, have you tried to apply for a federal job as a psych nurse? Maybe the veterans adminstration?

clahoney7 · May 11, 2012

I have been in CM in insurance for nearly 7 years, I cannot get back into bedside nursing as no one even calls.... . I would get some good RN bedside before going to CM, you can do the CM in the hospital...that being said, never turn down an interview!

Rasberry0708 · May 15, 2012

I have been in CM in insurance for nearly 7 years, I cannot get back into bedside nursing as no one even calls.... . I would get some good RN bedside before going to CM, you can do the CM in the hospital...that being said, never turn down an interview!

Just applied for CM job at an insurance company. Can you tell me what your job is like.

clahoney7 · May 15, 2012

After doing this since 2006-boring. I have moved on in my education but opportunities have just not been plenty due to the corporate offices being in another state or across the state as I am working in a regional office.

I work at a desk in a cubicle 8hrs per day talking on the phone and clicking computer screens. Some people are down right irate because their insurance doesn't cover this or that but most of my patients are grateful that I call and check on them. Following NCQA and URAC you have to ensure your documentation and process is flawless and we unfortunately have a flawed software that could be easier but the company refuses or cannot customize-I'm an informatics major (to graduate Feb 2013 with my MSN) and I would never have chosen the out-of-the-box software they have here. I get no extra compensation for my degrees or CCM where I currently work. It is the lowest paid because they say my benefits package-which they reduce yearly-is so "rich".

Other than the daily ho-hum, sit all day, snack and get fat :0), it's a job that is much better than the bedside if you are looking to reduce some stress-but, it does have stressors of it's own. And the more you do it the more it stresses you. In our last company wide CM meeting the last 15mins was how to reduce our stress!!!

clahoney7 · May 15, 2012

After doing this since 2006-boring. I have moved on in my education but opportunities have just not been plenty due to the corporate offices being in another state or across the state as I am working in a regional office.

I work at a desk in a cubicle 8hrs per day talking on the phone and clicking computer screens. Some people are down right irate because their insurance doesn't cover this or that but most of my patients are grateful that I call and check on them. Following NCQA and URAC you have to ensure your documentation and process is flawless and we unfortunately have a flawed software that could be easier but the company refuses or cannot customize-I'm an informatics major (to graduate Feb 2013 with my MSN) and I would never have chosen the out-of-the-box software they have here. I get no extra compensation for my degrees or CCM where I currently work. It is the lowest paid because they say my benefits package-which they reduce yearly-is so "rich".

Other than the daily ho-hum, sit all day, snack and get fat :0), it's a job that is much better than the bedside if you are looking to reduce some stress-but, it does have stressors of it's own. And the more you do it the more it stresses you. In our last company wide CM meeting the last 15mins was how to reduce our stress!!!

Rasberry0708 · May 17, 2012

Thanks for the information.

MintCondition · Aug 3, 2012

i learned most of my nursing skills from being a LPN so dont let that discourage you. i was a LPN for 7 years before i got my RN and the skill setting for LPN was much more knowledgable then being a RN. if you feel you would like to take a CM position then go for it especially if you learned the skills you needed from being a LPN. good luck