Case Management for insurance companies

TheCommuter, BSN, RN · Jan 10, 2016

In spite of my zero years of case management experience, I was recently hired into a CM position by a major insurance company. My 10 years of nursing experience includes acute physical rehabilitation, long term care, SNF subacute rehab, and psych.

However, I am uncomfortable mentioning the name of my employer on a public forum. It is one of the major insurance companies that every person in the U.S. has heard of. Good luck to you.

yzarcrn, BSN, RN · Jan 11, 2016

Hi!

I've never done case management, but I currently work in prior auth for a major insurance company. I only did beside nursing for 3 years before I started, so obviously had zero experience and absolutely no knowledge of insurance. I honestly am not sure why I was hired. Perhaps there were a lack of applicants at the time because I really was clueless. I picked it up quickly, however.

I do have one question. When you applied for these positions, were you given any sort of knowledge test by HR at any point during the interviewing process? I only ask because I had to take one. If you were given such a test, how do you think you did? Maybe they hired the other candidates because they had insurance experience or knowledge than you.

Also, I know that most insurance companies prefer a BSN for case management. Not sure if you have it or not, but if you don't that may be a reason as well.

Best of luck!

gonzoRN, MSN, RN · Jan 22, 2016

Have you considered a regional health plan vs one of the major ones? Many delivery systems are getting into the health plan biz these days. My health plan services over half a million people in my area, and the whole application/interview process was far less .... impersonal.... than the process for the major insurer that I applied to. Just a thought...

Work Injury RN · Jan 23, 2016

Hello, Since our company has a policy not to discuss opportunities on social media, and if you would like a response, please Email : [email protected] . I have a suggestion for breaking into case mgmt. without prior experience. If posting this address violates ALLNURSES TOS (which I reviewed) please advise.

jmiller1154 · Jan 26, 2016

I'm interested in this as well. And like you, have no experience in the field. I know there are several areas to go into in the insurance industry. I'm not sure which one would be a best fit for me. Are there certifications I can get to help me get hired? Any recommendations on breaking into this field?

jmiller1154 · Jan 26, 2016

Hi!
I've never done case management, but I currently work in prior auth for a major insurance company. I only did beside nursing for 3 years before I started, so obviously had zero experience and absolutely no knowledge of insurance. I honestly am not sure why I was hired. Perhaps there were a lack of applicants at the time because I really was clueless. I picked it up quickly, however.
I do have one question. When you applied for these positions, were you given any sort of knowledge test by HR at any point during the interviewing process? I only ask because I had to take one. If you were given such a test, how do you think you did? Maybe they hired the other candidates because they had insurance experience or knowledge than you.
Also, I know that most insurance companies prefer a BSN for case management. Not sure if you have it or not, but if you don't that may be a reason as well.
Best of luck!

yzarcrn,

What does your job entail? And do you enjoy it more than bedside nursing? Is there room for growth?

I'm happy to hear that you picked it up quickly. I'm looking to break into the insurance industry as an RN, BSN but have no experience in that area. I was an ER nurse for 2 years and a Labor and Delivery nurse for 2.

Thanks!

olbond87 · Feb 9, 2016

I`ve never done case management before. But I have been working with very simple case management software for 3 months already. Honestly, it`s easier than you think.