Cm after being gone

madmominavan · May 9, 2008

I left Critical care to find a family friendly position. Ended up taking a Cm course at a nearby University, got significant number of hours as CEU and was able to put them towards a BSN-MSN accel course at a local college. Took off work for college for two years and am now re-entering the work force as a Case manager. Depending on the facility or corporation you chose to appy and work, there may be a refresher or training course if you have not taken Cm courses. There are so many opportunites for Cm such as home care, acute care, rehab, drug/ETOH, mental health, etc.

Do some research online about Cm and look at job boards. CCM board can be contacted for information and requirments. Also check that if you are working for an insurance agent or a trade union agent if you need to be licensed and certified in other states. Ask if the employer will pay for the certifications you have to apply for or take tests for.

Hope this is helpful... in getting started.

I worked for several years in an acute care hospital in critical care and became the case manager of the dept including dialysiss, transplant and telemetry units. Then when I left I took on a UR/pre-cert position and covered for case managers out for the day or on vacation because of my experience. I applied for the Cm position when there was an opening and loved the job & fit in with the people in the corporation; had great mangers and bosses and opprotun ity to learn andget ahead with certifications asa result. While it was mostly telephonic, I did meet with clients such as blue cross & Blue shield, Railroad worker's, Steel workers Postal workers all across the USA and abroad. I also was able to build a relationshiop and trust of physicians who relied on my managing some patients- inparticular ones who were er hoppers, missed appt., drug seekers, poain control issues , monthly drug treatments, capturing savings, negotiating rates for room and board at different levels of care, drugs and IV meds given at home with services. Home care, Long term care for infants and chilren with all kinds of chronic illnesses. I learned about what is covered when someone is going for experimental drug therpaies. like bllod work ordered by MD... not the experimental group. I was able to network and have a liason with advanced practice nurses and otehr health care diciplines. It is a facinating job with so many good opportunities for nurses. Good luck!

rednails · May 10, 2008

Thanks so much madmominavan. Very much appreciate the input. It does sound really intersting and totally different. I'm looking forward to the possibility. I just heard about a resource position possibly opening up through a friend (she loves being a CM) who's referring me. Hoping someone will take a chance on me that way (resource)! lol. Position is hospital based. I did find out too they require you to take the test within a certain amount of time..two years? I'll keep researching the net too. Thanks again. God's timing, but I'm excited with the possibility!

madmominavan · May 11, 2008

I am a member of the CM Association. There is a guide line book online you can print out. Itis for any Cm particularly hospital based nurses. CM Handbook can be ordered on line or in any University book store. Barnes and Nobles and Borders. Would suggest getting one... it is the Bible for Cms. The cost of a course in your local can be expensive but worth every penny. Also the CMA has sample tests for review. Follow the guide the questions on the certification tests; follow the handbook and test guide- each gives you some of the categories. If you have a chance down the road take an insurance course. They also an be done online. I will look for my books and send you the names or information.

I have worked for both sides... hopsital, workeman's comp and the corporate side as an agent for major trade union insurances as well as IBC/BS, AETNA, BC/BS and other insurnaces. I found several private insurances in the midwest , Oklahoma and Alaska to be somewhat risky fort the clients but, was always able to advocate and negotiate for my cleints. An average caseload for hopsital CM is 50. I have more at times and I have a larger case load of long termers. In the corparate side I had up to 200 cases. Some could be closed or placed on an inactive status or are diaried becasue theyonly need month to month reviews or authorizations. Right now I have a resource for those who have no insurances who will fund as long as we use a local/state network. I happen to live in a county in PA that has many resources for services and we now have a free clinic that we can refer pt. so they stay out of the ERs. I always thought I would be wearing white and growing fat and remaining in the hospital, but the opportunity for nurses especially older boomers like me are vast. I found my nic and really like it. Good luck. :wink2: