opinion re: care coordination RN

  1. I have an interview for a care coordination RN/Case Mgr job with a major insurance company. Honestly, I have no experience in case mgmt and the job description describes contacting members via phone to id risks for readmission to hospital. I wondered if anyone else has worked this kind of job or knows more what to expect. I was surprised they called for the first interview and now I have a second one scheduled next week. The hours are great and the pay adequate especially with limited experience. Is it too good to be true?
  2. Visit teegeo profile page

    About teegeo

    Joined: Mar '04; Posts: 15
    RN -- oncology


  3. by   caliotter3
    I've managed cases before, but not in the manner that you describe. The best advice I can give you is to be open in the interview about your willingness to learn the procedures and tasks. Try not to shoot yourself in the foot about your lack of experience. More than likely, the second job offer will give you a better chance at getting hired. Good luck to you in your job search.

    Added thought: Ask them if they have protocol lists that you can refer to. They probably do. BTW, I used to work with an LVN who was hired to be a phone advice nurse in neurology and she had no experience in neurology. She said that it doesn't take long to get very knowledgeable, and she had protocols to follow. Basically, it is your ability to elicit info from the patient so your interviewing/assessment skills will be evaluated. Again, good luck.
    Last edit by caliotter3 on May 11, '07 : Reason: Added thought
  4. by   dria
    teegeo...i am 99% sure i work for the same company in another location in the same role. send me a pm and i will tell you everything you want to know!!!
    your lack of case management experience will harm you in no way. as stated above, play up your willingness and ability to learn a new role. during my interview, i told the interviewer that the advantage to my inexperience was that they could teach me to do it exactly the way they wanted it done. obviously, it worked for me!
    get in touch with me before your interview, and i will be happy to tell you more....
  5. by   rummy2
    I too think that I have worked for the same company in a different location. I found it to be stressful as it was an environment of constatnt change. I had years of experience behind me which didn't seem to benefit me much as they did things completely different than anywhere else I had been. I found that if you are extremely easy going and don't mind constant change - you will do well in that environment
  6. by   CCL"Babe"
    I too work for a large insurance company. I have a different job than what you describe but am aware and know people who do that kind of work. It is the trend within the industry. If the company that you are interviewing for is anything like mine computer skills are your best asset in the begining. Our orientation to the company prior to dividing into specialties was about four months. Our company gives basic scripts to follow for the initial interview.
    For my interview I went on the web and found out all I could about the company. I formulated my questions based on what I learned and what I wanted to know more about.

    Good luck. It was the best move I ever made.
  7. by   dria
    never heard back from you....just wondering how your interview went for you...?
  8. by   Katie82
    I had a similar job for an insurance company. The training was very good, and they usually provide you with algorithms to assist you. Most companies provide CM data programs that will factor the risk assessment for you. Go for it...
  9. by   Tangerine Lipgloss
    Is it difficult to deal with members all day? How about with the doctors?

    I had an interview for a CM position, and it has heavy member/client interaction as part of the job. I have no problem with this, just wondering how it is.
  10. by   dria
    i find the interaction with the members to (usually) be the easiest, most enjoyable part of the job. the biggest challenge i've found is assessing needs based on telephonic interaction. you lose a lot not being able to lay eyes on these people.

    doctor's offices.....they're 50/50. either they're on board and really collaborative and helpful, or they are suspicious and won't give any info until we send the hipaa notice. luckily, interaction with the doctor's office (in my role) is minimal....maybe 1-2 x/week. usually it's better to encourage the member to take an active role in his/her healthcare and take care of whatever the issue is.

    i'll be keeping my fingers crossed for you about that interview...be sure to let us know the results!
  11. by   Tangerine Lipgloss

    Thank you for your informative answer to my post.

    I was also thinking of the challenges of assessments and teaching over the phone.

    I don't have any case management experience, but would like to learn this field. I think I would like it. I would be able to still help people but not have to be on my feet for 13 hours.

    In this job I would have to interact with doctors that are in the hospital. I would be dealing with inpatients from admission to after discharge home.

    Thanks for your well wishes too. I should hear either way this week sometime.
  12. by   Katie82
    I recently left a CM job with an insurance company when I moved. You will be working in an area we called Concurrent Review. My job involved picking up where you left off, when they went home. I loved it... I also worked for a company that treated their patients well, so that made it easier. Docs are not really a problem if they think you care about their patients.
  13. by   cooked123
    Hey Teego, I am called "Clinical Outreach Coordinator", and the nurses that work for/with me are of several roles: RN Coach telephonically, RN Coach on site at large corp to encourage and spearhead positive health-oriented education and tools for the employees, Disease Management RN, both medical and behavioral health. THese work on the phone and at the home with otherwise non-compliant or disadvantaged clients to help the patient practice good habits, comply with meds, they go to physician with patient, give lots of phone education and education in person after being in the home (and seeing inside the fridge). All my staff have criteria set forth similar to an algorithim, have on-line criterria by M&R and INterQual for reference help, and help each other. Vary rewarding to be a RN Care Coach. Good Luck, enjoy!
  14. by   Tangerine Lipgloss

    I got the job offer! I'm due to start in a few weeks. I'm pretty hopeful that this job works out well.

    Can anyone recommend any good books I could read to prepare?