Hello All,

What is a case management and what do they do? How would I get more information on that career? Is there any suggestions on how to get experience one for a person who does not have any experience at all? Would it be best to take case management classes? I am trying to get away form bedside nursing. I have a BSN and currently pursuing a Master of Arts in Health and wellness. I am just looking for Ideas.

Thanks all so much!!

Peaceful nurse


282 Posts

cmsa.org would be a good start. But briefly, hospital case managers do one or all three of the following. UR: reviewing admissions and continued stays for medical necessity using standard criteria (InterQual or Milliman) and getting that info to HMOs 2. Discharge planning : assessing post d/c needs and setting them up. 3. expediting the plan of care to decrease the length of stay (i.e.: proding the attendings ). There is also HMO insurance company cms that do 1 and 2 with an authorization / denial responsibility. Also PIP, Workers comp/ disability case mgmt who also do 1-3 but in a different way. There are graduate level case management courses but I don't know anyone who ever took them. Without a doubt the easiest way to get into cm is convince the Director that you have the aptitude and attitude to be able to learn and do 1-3 (and are not just trying to get away from the bedside).

Thank you so much. That is great advice. I really appreciate the help. :)

Peaceful Nurse

Specializes in Obstetrics/Case Management/MIS/Quality. Has 18 years experience.

i recently made that change myself last fall. i had been a bedside nurse for 12 years and desired an opportunity to learn something new. i took a chance on a case management position and it has turned out to be wonderful! :yeah: i'm so thankful that i gave it a shot! i am able to use my nursing experience to do more than run my body into the dirt by the end of 12 hours! now, i still work 12 hour shifts, but i don't get as physically exhausted as working on the floor. i still am able to have the patient contact that i love and am able to facilitate positive change in their lives, just in a different way. i would say that you should read up a little about the field of case management and if still interested, see if you could shadow one at the hospital for a day or two. this would give you a chance to experience the pace and the responsibilities. i hope you find that you love it one day as much as i do! :up: