You are in a great area to get into Case Management. LA has a big market. Your home health experience will be extremely useful. Depending on which are of case management you are interested in, it can give you the kind of atmosphere you are looking for. You have to find your "niche" in this speciality as with anything else.
There are several areas where you can get your foot in the door with case management. One is doing hospital discharge planning. This gives you a good way to utilize your clinical knowledge and apply it when assisting and moving the patient along the acute care continuum. It also still keeps you in the clinical setting and working with physicians. This will also train your skills in diplomacy - having to work with payors and insurance companies!
That is something that is definitely needed.
Another area is for an insurance, third party payor (TPA), or consulting firm. With an insurance company, you may be reviewing authorization requests for the length and frequency of home health visits (which you will know off the back of your hand if they are appropriate or not) and other medical treatments that the insurance company has the doctor request prior authorization. With the TPA, you would be acting on behalf of the payor source making recommendations for appropriate medical care and authorizing according to their standards. In the consulting firm (Concentra, Intracorp, Rehab West, Professional Dynamics - all their in LA area) you would take responsbility for a specific patient's treatment course while working with the payor source.
You have many avenues in case management - I would hire home health nurses and train for case management because I felt they had the knowledge and ability to properly manage a case. Of course, that's after an interview where I could question them on their analytical skills and problem-solving techniques. One of my best staff members came straight out of home health!
Hope that helps!