ROLL CALL - Case Managers!!! - page 7

Time for a roll-call for the Case Managers on the board!! I'm here in Vegas, got my CCM in 1999, Medical & Disability Case manager for PPO network & Utilization Management company.... Read More

  1. by   kTIE
    Katie RN, BSN, CCM, got my CCM in 05. Worked in Hospital base case management and now I am transitioning to a medical group ( also hospital based).
  2. by   areeve01
    Hi, I am RN been in CM/UM for over 6years, currently working in a couple different ventures. First being, full-time for a Medicaid healthplan who provides Managed Care insurance contracted thru the State. I get to work from home.
    My second, is doing independant consulting for a new health organization that is completely computer based where nurses get to work from home and provide public health as a nurse advocate in their area to different clients, in Indiana, Alabama, Mississippi, New York and soon to be in Georgia.
  3. by   buzzey
    Quote from hoolahan
    EXCELLENT idea Las Vegas!!!

    Linda, RN BSN, working on CCM exam this October. Started out in case management in Home Health, then did disease management for a managed medicaid co for a short time, now doing worker's comp CM, field-based. I am still figuring out if I like it. I really want to go independent in the future.

    I am also planning the CCM in October and would like to explore doing independent case management. Has anyone found any helpful information on starting a business as an independent case manager? What type relationships have supplied the most referrals? How is the service priced when working independently? How do you convince a third party to pay for your service? What has been your biggest challenge? Looking for any information that can help me develop a realistic business plan.
  4. by   buzzey
    Can anyone supply information on starting out as an independent case manager? How do you get referrals? Although it can be rewarding, is it cost effective? How do you price the service? What are the biggest challenges in doing independent case management? Thanks for sharing.
  5. by   ARnurse69
    I work as a case manager in acute care & will be eligible to sit for CCM this fall. I have my ADN, but most job postings I've seen for case management want a BSN, including our sister hospitals. Can anyone tell me if it would be more beneficial to start classes now for my BSN, or to start studying for CCM first? I think it would be too much to do both at the same time, although I do plan to do both eventually. Thanks!!!
  6. by   BahaMamamaRN
    I am starting my first job as a RN Case Manger on Monday. I work in a LTAC hospital in the Midwest. I am excited and nervous at the same time. I have been a nurse for 15 years.
  7. by   charna
    Congrats BahaMama and so nice to see all of the other Case Managers here.
    I'm work in NY and have been in case management for the past 5 years. I've worked in telephonic case management in managed Medicaid, then moved onto disease management, where I assessed my clients face to face as well as telephonically. Now I am working in managed care case management in a certified home health agency and I really enjoy it.
    I will be taking the CCM exam later this year. Best of wishes to all of you that will also be taking it.
  8. by   DaveMac
    I took the Discharge Planning Utilization Review job last year, March 2007. The job also includes Infection Control and Employee health. I had been assisting the DP/UR nurse for a couple of years so she could attend classes, meetings, and time off for good behavior. So I had a little background in what the job involved. Don't know if CCM is in the future or not. ICP is in the future plans for 2009, that will be 2 yrs in the field. Being in a small hospital (<100 - really <53 - normal census 10 - 22, avg, 12) you would not think it would be a problem with the 4 roles. Doing InterQual takes so much time, then the doc's want placement, DMEs, or whatever right now, usually during lunch or as I leave in the evening. Top it off, when they arrive, they insist on having all the charts and you can't do InterQual, we are not computer charting yet, maybe within 2 - 4 years MediTech will be to that point here. We are just now setting up for order entry.
    So between the 4 roles, I am on the average, a few days behind in my jobs. The CNO says that I need better time management. The CEO, CFO, HIM, and Business Manager say I need a second person to assist me. Any advice would be welcomed. BTW for a hospital of <100, what is the FTE, anyone know? I think it is 0.8 FTE.
  9. by   finn11707
    I have been a Hospice Case Manager for 6 years and, before that, for another hospital, a Home Health Case Manager from 1987-1999. Neither agency required nor encouraged CCM or a Bachelors!
  10. by   ARnurse69
    Is anyone planning to take new computerized CCM this fall/winter? I've completed all the steps to apply. Now, just waiting (& trying to study!) for confirmation that I can sit for the test.
  11. by   CaHxQday
    Hello from Houston, TX!
    I am a Patient Access Services RN. My background before coming to Case Management on the hospital side was in Utilization Review in an IPA, then in two insurance companies. I learned a lot and was delighted when I made the change back to the hospital side of things with all the pearls I learned in Utilization Review.
    We provide the clinical and Pre D's to insurance CM and UR nurses to obtain auth for cancer tx, most of which is outpatient services. We obtain auth for inpt admissions, but our inpt CM's do concurrent review. It is a real team effort. While insurance companies get a bad wrap at times, we have a real appreciation for working with sharp insurance CM's and UR RN's who are patient advocates like we are. We know that nurses do the best they can to help us help patients and sometimes, it is a simple matter of insurance benefits or lack of. Always a nurse first! I love what I do. Patient Access is a pretty new specialty and requires insurance nursing experience. I have done it long enough now to have seen a lot of growth and change. Pretty exciting area and I work 8-5, no free ot is expected of me anymore. The patient contact is really nice. It is very rewarding and the salary is nice. Anyone else in Patient Access?
  12. by   redkill99
    Hi, just joined this group and trying to figure it out!! I'm waiting to hear also, if my application is accepted for the Dec. exam. I think we're suppose to know by Sept 30th.
  13. by   kathall
    I have just joined an interdisciplinary team as a RN/case manager for home based primary care. This is a fairly new program started by the VA about a year ago. I am now working on a BSN and will probably work on a certification afterwards. I could use any words of wisdom from veteran case managers.