Case Mgt unattainable goal

[ItalianRN, BSN, RN]

Why is it so hard to get into case management if you don't have experience? Everyone in it had to start as a CM without experience at one point in their career. I'm really starting to believe that it's not what you know, it's who you know. Without a friend to pull for you, a CM position is impossible to obtain. So frustrating!!!!

[nurseprnRN, BSN, RN]

For what it's worth, my opinion is that case management used to be that easy-peasy job where tired staff nurses went to work out their years to retirement, schmoozing their way around the hospital, arranging SNF discharges, and taking long lunches. I hasten to add that this was years ago, but many people still think it's sorta like that.

Nowadays, though, with managed care in many areas, including mandatory elements of worker's compensation insurance, HMOs, Medicaid, Medicare, RAC, and associated regulations, case management has evolved into a real specialty with specialty certification to recognize mastery of many diverse elements-- insurance, healthcare finance, reporting, fraud recognition, documentation, credentialing, research-based practice, interspecialty and interagency communication, and much more. Therefore it's harder for someone who manages a busy hard-working case management department to bring in rookies and spend a lot of time training them, only to lose them. The margins are so small these days that it's very difficult to take that risk.

I'd say if you want to be that rookie, start with a very broad experience base in nursing, very broad. A year or two isn't going to cut it in most settings. Develop excellent writing and analysis skills. Take the time to join the local CMSA chapter, take a slug of CE in case management, network, shadow, and do what you have to do to convince someone to take you on, because you have already put in some time and are less likely to quit in surprise.