insurance companies?

Specialties Case Management

Published

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I have been an RN for 7 years. Worked sub-acute unit, charge nurse on tele/oncology at hosptial and now am at the health department. I was wondering if I look in the Insurance companies for CM work am I qualified without taking more education? Do most places want you to have CCM? Will they do much training? Is that the best place to start out? I just really need a career change!!!! I love being a nurse but getting to hate my job.

How did you get to be a CCM without a professional credential? Everything I see says you have to have a professional license in order to even sit for the exam.

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How did you get to be a CCM without a professional credential? Everything I see says you have to have a professional license in order to even sit for the exam.

I have an M.A. in Rehab, a CRC, a CDMS. and .. I forget how many years of case management experience they required, but I had them. Board certifications count like nursing licenses do.

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I work as a worker's comp case manager for GENEX and I love it!!! GENEX is VERY good to their employees. My home branch is about 300 miles from me so I work out of my home.

Erin :eek:

Can I ask you what path you took to get to where you are now?

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Lizzy6------Just wondering if you could give me any ideas of how to find a work from home case management position, or what companies to look at......Thanks

I worked for UnumProvident, Pacificare, and Aetna. Someobody here wrote that she works for Genex. They hire a lot, too. Zenith, all the Workers Comp companies. The Blues are supposed to be good to work for.

Most of case management is like utilization review-just common sense, within guidelines!

I did that for a LONG time. :-)

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Specializes in Med-surg, transplants, case management,.

I have been a WC case manager for about 10 years. Had more than 15 years in the hospital before that. I have done telephonic in an office and field from home. Telephonic is more 8 to 5 than field is but field has more flexibility. You can take an afternoon off if you want without taking PTO if you make up the time which is easy to do when you can write reports from home at night. The big WC insurers are ESIS, Sedgwick CMS, Gallagher Bassett and AIG. The big WC case management companies are Coventry health care (they bought out Concentra), Corvel, Genex and Intracorp. I love case management and the autonomy of not having anyone breathing down your neck all of the time. When I was working in the field my bosses were all at least 50 miles away and one of my bosses was almost 200 miles away. You can talk to them on the phone whenever you want but it is nice not having them right there. I now write life care plans for the catastrophically injured and love that but I do miss the people contact that I had in the field. Lots of luck.

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I have been a WC case manager for about 10 years. Had more than 15 years in the hospital before that. I have done telephonic in an office and field from home. Telephonic is more 8 to 5 than field is but field has more flexibility. You can take an afternoon off if you want without taking PTO if you make up the time which is easy to do when you can write reports from home at night. The big WC insurers are ESIS, Sedgwick CMS, Gallagher Bassett and AIG. The big WC case management companies are Coventry health care (they bought out Concentra), Corvel, Genex and Intracorp. I love case management and the autonomy of not having anyone breathing down your neck all of the time. When I was working in the field my bosses were all at least 50 miles away and one of my bosses was almost 200 miles away. You can talk to them on the phone whenever you want but it is nice not having them right there. I now write life care plans for the catastrophically injured and love that but I do miss the people contact that I had in the field. Lots of luck.

Nursemaryl,

It sounds like you work for or worked for Coventry formerly Concentra just by naming their jumbo accounts. Are you still with them? I was recently hired by them and would have been laid off except I went back to my former employer because I was not getting the referrals to keep up my full time hours.

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Specializes in MCO, Acute Rehab, triage, med/surg.
I work as a worker's comp case manager for GENEX and I love it!!! GENEX is VERY good to their employees. My home branch is about 300 miles from me so I work out of my home.

Erin :eek:

Hi Erin,

I too work for Genex!! I love it! I do some in-house case management, but mostly Utilization Review. When I have to miss going to the office, it is no problem... I can work from home.

And you are absolutely right... Genex is a great company to work for.

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Specializes in Med Surg, Tele, PH, CM.

Case Management is going to be a wide-opem field a more agencies are realizing its value. I work for a non-profit that has been tasked by our state to manage Medicaid patients. I love it. I worked for a MCO before I moved here, doing the same thing. CMS is now pushing to put Medicare beneficiaries in Managed Care /Case management - they really need it. We are going to start phasing in the Medicare population and will have our hands full. A lot of the major insurance companies also have Medicaid MCOs in some states. Your health department should have some sort of Medicaid Coordinator who does Case Management. Lots of opportunities - just stay away from Disease Management.

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Thank you...its funny that you say that..."stay away from disease management" because i just quit my job about my 4-5 months ago in disease management...at home telephonic...hated it...i like managing patients but not in that realm of nursing...

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Thank you...its funny that you say that..."stay away from disease management" because i just quit my job about my 4-5 months ago in disease management...at home telephonic...hated it...i like managing patients but not in that realm of nursing...

What company did you work for? I work disease management with some case management and really like it. I don't think I would like working from home.

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Worked for Mckesson...liked the company..just didnt care for dm...and didnt like being at home all the time, had to make so many calls a day...everything was so crituqued (?SP)...

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Specializes in Hemodialysis, OR.

Hey out there;

I have an interview with an ins. company for a disablity case manager on Wed. It would be my first case managment position. Any advice would be welcomed.

Thanks.

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